Regulatory Production Specialist II (Remote Options)

Date: May 13, 2022

Location: Rancho Cucamonga, CA, US

Company: Inland Empire Health Plans

Job Requisition ID: 7051 

 

Position Summary/Position

 

The Regulatory Production Specialist II will be responsible for managing day-to-day operations of a portfolio of regulatory member communication projects and providing support for ongoing regulatory communication campaigns. This role will be responsible for ensuring program activities are completed at a high quality and in a timely manner while ensuring compliance with all regulatory guidelines and timelines. The Regulatory Production Specialist II will be responsible for the coordination and completion of submissions to Federal and State regulatory agencies including DMHC, DHCS, and CMS. In particular, the Specialists’ portfolio will encompass all regulatory member materials for all LOBs including Medi-Cal, CMC, and the future DSNP product – to include the Provider Directory, Formulary, and Member Handbook.

Major Functions (Duties and Responsibilities)

 

1. Provide regulatory member communication activities coordination and advancement, including but not limited to, development of regulatory member materials, compliance monitoring and reporting, managing and preparing submissions of regulatory member communication to federal and state agencies, and printer vendor management.
2. Develop regulatory materials for all LOBs including the Member Handbook (EOC), Provider Directory, and Formulary.
3. Assist in the development and implementation of regulatory communication strategies, processes, including design and development changes, to ensure timely completion of member materials in compliance with applicable regulations and standards
4. Ensure compliance of regulatory member communication, including but not limited to, the provider directory, formulary and member handbook, with all marketing guidelines and regulatory policies. 
5. Act as the liaison between the enterprise and translation vendors to ensure completion of translations for all regulatory member materials for all lines of business.
6. Work across the enterprise to facilitate the intent of regulations and policies and provide such recommendation to Marketing & Communications project teams and management.
7. Collaborate with internal and external partners to collaborate and synergize actions and processes to ensure standard work and standard reporting requirements and opportunities for improvement.
8. Monitor and coordinate the completion of regulatory Member mailings including the validation of insertion sequencing and mailing quantities.
9. Work with print vendors to ensure that proof of delivery statements are received timely for all regulatory projects and accurately maintain regulatory compliance records.
10. Organize the RFQ for annual and new member regulatory project bids for all lines of business and process in the financial system Oracle.
11. Perform regulatory submission assessments to validate completion of approval or renewal status. 
12. Adhere to the quality assurance standards of all regulatory materials including following strict regulatory requirements and standard of work.

Supervisory Responsibilities

Leading: Self

Experience Qualifications

 

Minimum of five (5) years in Medi-Cal and/or Medicare managed care with regulatory marketing, enrollment, and member communications guidelines. Five (5) years of experience in a managed care environment with experience in managing complex projects, workplans and project management tools.

Preferred Experience

Education Qualifications

 

Bachelor's degree from an accredited institution required.

Preferred Education

Professional Certification

Professional Licenses

Drivers License Required

No

Knowledge Requirement

 

Thorough knowledge of Medi-Cal and/or Medicare managed care in terms of regulatory Marketing, Enrollment, and Member Communications guidelines. Understanding of and sensitivity to a multi-cultural environment and community.

Skills Requirement

 

Must have strong project managements skills. Excellent writing, interpersonal, communications skills.

Abilities Requirement

 

Must have a high degree of patience and attention to detail. Demonstrate problem solving capabilities to resolve concerns that arise unexpectedly.

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

 

Using computer keyboard and screens. 

Physical Requirements

Keyboarding: Traditional - FREQUENTLY
Keyboarding: Touch-Screen - FREQUENTLY
Keyboarding: 10-Key - FREQUENTLY
Hearing: One-on-One - FREQUENTLY
Communicate: Information/ideas verbally - FREQUENTLY
Near Visual Acuity - FREQUENTLY
Sitting - CONSTANTLY
Lighting - CONSTANTLY
Indoors - FREQUENTLY
Regular contacts: co-workers, supervisor - FREQUENTLY
Memory - FREQUENTLY
Understand and follow direction - FREQUENTLY
Regular and reliable attendance - CONSTANTLY

 

Starting Salary: $61,422.40  - $78,312.00  

Pay rate will commensurate with experience

 

Inland Empire Health Plan (IEHP) is the largest not-for-profit Medi-Cal and Medicare health plan in the Inland Empire. We are also one of the largest employers in the region. With a provider network of more than 6,000 and a team of more than 2,000 employees, IEHP provides quality, accessible healthcare services to more than 1.2 million members. And our mission and core values help guide us in the development of innovative programs and the creation of an award winning workplace. As the healthcare landscape is transformed, we’re ready to make a difference today and in the years to come. Join our Team and Make a Difference with us! IEHP offers a Competitive salary and a benefit package with a value estimated at 35% of the annual salary, including medical, dental, vision, team bonus, and retirement plan.

 


Nearest Major Market: Riverside
Nearest Secondary Market: Los Angeles