Regulatory Affairs Liaison - Medicare (Hybrid Work Schedule)

Position Summary/Position

Under the direction of Regulatory Affairs Manager, the Regulatory Affairs Liaison will be responsible for communication, stakeholder management and facilitation, issue management, response and mitigation and regulatory change implementation.  
This position will act as a liaison between several operational departments to facilitate communication, manage relationships with stakeholders and garner support and agreement from involved units for compliance initiatives and programs. This position will provide expertise and knowledge to support issue and change management processes, facilitating change management efforts as needed. Issues and projects assigned for this position will generally be high-to-critical/size of complexity.  This position will be involved with regulatory change management and communications of projects and issue management at the Manager, Director, and Chief levels.

Major Functions (Duties and Responsibilities)

1. Provide research, analytical support, and project management in the areas of issue resolution, implementation of regulatory changes, strategic projects, and configuration and processes that are in the best interest of supported business operations.
2. Manage large, high complexity, and high-risk issues and projects inclusive of business, regulatory, or technology deployments (inclusive of project budgets and acquiring resources with agreements from functional areas, 3rd party vendors, and consultants).
3. Responsible for issue management, response and mitigation for assigned business units. Anticipates issues through regular communication with reporting positions, mitigating risk or escalating issues for resolution by more senior levels as necessary.
4. Participate in Policy & Regulatory Operations R.A.C.E. events as a liaison for Regulatory Affairs.
5. Facilitate regulatory change implementation workgroups between business units as assigned.
6. Coordinate, prepare, and monitor assigned projects, documentation and report outs.
7. Act as a liaison between Compliance and assigned departments for related activities to ensure projects and issues are tracked, updated, and reported out frequently as scheduled.
8. Monitor and track Corrective Action Plans (CAPs), audit findings and regulatory change management to ensure that interventions are completed to mitigate risks and issues.
9. Assist in responses and completion of regulatory deliverables.
10. Capture process efficiencies developed through projects and incorporate LEAN methodologies into project practices.
11. Stay abreast with regulatory and contractual requirements as appropriate.
12. Support the department on special company-wide projects and initiatives.
13. Coordination with business units and oversight of audits, gathering of materials, responses, practice sessions before a regulatory audit, and meeting deadlines for timely responses.

Supervisory Responsibilities

Experience Qualifications

Minimum of five (5) years of relevant experience in government programs and/or leadership and/or healthcare. Strategic and analytical thinker with experience in compliance and project management. Expert experience with machine learning, statistics, and informational retrieval.

Education Qualifications

Master’s degree from an accredited institution required.

Significant experience may be considered in lieu of a Master’s degree: In lieu of a Master’s degree, a minimum of a Bachelor’s degree with seven (7) years of relevant work experience is required.

Professional Certification

Relevant certification (i.e., PMP, HCCA) preferred

Drivers License Required

Knowledge Requirement

Knowledge of CMS, DMHC and/or DHCS requirements a plus but not required. Ability to develop plans and has knowledge and application regulatory requirements.  Strong ability to translate data into meaningful and actionable information. This position provides key operational information and key organizational tactical / strategic information through the effective implementation of data initiatives. Initiatives include data trending analyses, data profiling, data mining, data analysis, and promoting a data-aware culture throughout IEHP. An understanding and sensitivity to a multi-cultural environment and community.

Skills Requirement

Must possess ability to project manage, facilitate cross-organization coordination and quickly analyze regulatory requirements. Strong interpersonal skills; strong project management skills, strong issue management skills.  Microcomputer applications: spreadsheet, database, and word processing.

Abilities Requirement

Must support a culture of collaboration; must have excellent writing, interpersonal communication, organizational skill. A high degree of patience; attention to detail; ability to work in changing, fast-paced environment.

Commitment to Team Culture

The IEHP Team environment requires a Team Member to participate in the IEHP Team Culture. A Team Member demonstrates support of the Culture by developing professional and effective working relationships that include elements of respect and cooperation with Team Members, Members and associates outside of our organization.

Working Conditions

Some travel within California may be necessary.

Physical Requirements