HCP Talent
Regulatory Affairs Associate - Managed Long Term Care (MLTC)
Compensation: $150K-$170K per year
Job Type: Monday through Friday, 9:00 AM to 5:00 PM. This role will be fully onsite for the first 90 days during the probationary period. After that, the position transitions to a hybrid schedule: 3 days in the office and 2 days remote.
Our client, is seeking a Regulatory Affairs Associate to support and coordinate compliance activities within its health plan operations. This position plays a critical role in ensuring regulatory alignment across various programs, contracts, and legal matters, including CMS, DOH, OIG, and OMIG compliance.
Responsibilities
Salary : The posted range is not a guarantee. The actual salary will be based on qualifications, experience, and education and could fall outside of this range. Contact us for more information.
If you're excited about the potential of this role, we'd love to hear from you!
Compensation: $150K-$170K per year
Job Type: Monday through Friday, 9:00 AM to 5:00 PM. This role will be fully onsite for the first 90 days during the probationary period. After that, the position transitions to a hybrid schedule: 3 days in the office and 2 days remote.
Our client, is seeking a Regulatory Affairs Associate to support and coordinate compliance activities within its health plan operations. This position plays a critical role in ensuring regulatory alignment across various programs, contracts, and legal matters, including CMS, DOH, OIG, and OMIG compliance.
Responsibilities
- Draft, review, and negotiate provider and organizational agreements in accordance with internal policies and compliance standards.
- Lead and manage data collection and submissions for external audits, surveys, and government requests.
- Oversee provider contracting processes and manage follow-up communications.
- Administer Fair Hearing (FH) cases, including calendar management, case prep, documentation, and hearing attendance.
- Handle regulatory reports and provide updates on ongoing cases and investigations.
- Participate in Special Investigation Unit (SIU) functions, including compliance reporting and internal investigations.
- Update HIPAA-related policies and procedures to ensure compliance with current regulations.
- Maintain awareness of and ensure adherence to OIG and OMIG compliance practices and requirements.
- Review state and federal plan contracts to ensure consistency with regulatory standards.
- Distribute and interpret CMS and DOH updates, memos, and official regulatory guidance.
- Coordinate document production in response to legal matters or litigation requests.
- Maintain internal databases related to provider credentials and other compliance documentation.
- Draft and revise internal policies, procedures, manuals, and member-facing plan materials.
- Supervise and provide oversight to department support staff.
- Juris Doctor (JD) from an accredited institution
- Minimum of 3 years' experience in managed care compliance, credentialing, or contracting
- Familiarity with MLTC, MAP, Medicaid, and Medicare program regulations
- Demonstrated leadership or supervisory experience
- Strong legal and analytical skills related to contract review and compliance oversight
- Proven ability to handle investigations and recommend practical solutions
- Medical
- Dental
- Vision
- 403B with employer match
- Life insurance
- Flexible Spending Account
- Employee Assistance Program (EAP)
- Pet insurance
- Tuition Reimbursement Program
- PTO
Salary : The posted range is not a guarantee. The actual salary will be based on qualifications, experience, and education and could fall outside of this range. Contact us for more information.
If you're excited about the potential of this role, we'd love to hear from you!