Regulatory Affairs/Contract Administrator
Phoenix AZ 85034
Job DescriptionThe Regulatory Affairs/Contract Administrator is responsible for maintaining the organization's relationships with state and federal regulatory agencies with jurisdiction to monitor and oversee adherence to its contracts to operate in various government programs and otherwise assures that regulator(s) deliverables and expectations are met by the business. This position requires effective leadership as a subject matter expert in government programs and healthcare regulatory requirements, balanced with the ability to complete a variety of detailed analyses and assessments, including the on-going evaluation of the impact of State and Federal regulatory changes on the organization's programs and related state-sponsored government programs. This position leads and manages projects and initiatives driven by state and federal regulatory requirements. The Regulatory Affairs/Contract Administrator will work to ensure the objectives of the organization are met, especially the establishment and maintenance of a productive, communicative, and transparent relationship with various state and federal regulators (e.g., Medicaid agency, Departments of Health or Insurance, CMS), exercising advocacy on behalf of the health plan as appropriate. This position will closely partner and collaborate with business leadership, department management, employees at various levels, and legal counsel, as well as regulatory agency contacts. This position also supports Public Sector Compliance and organizational leaders and staff on related initiatives.
- Leads and maintains the day-to-day relationships with state and federal regulatory departments/agencies with jurisdiction to support contract compliance and business operations in the Medicaid/Medicare program(s) in which the Magellan Complete Care health plan participates.
- Analyzes, interprets and serves as thought leader in business decisions regarding the regulatory implications of changes to statutes, regulations, sub-regulatory guidance, and contracts.
- Leads and facilitates regulatory audits and audit readiness activities.
- Leads and facilitates the submission of regulatory filings and reporting deliverables on an ongoing basis.
- Leads the process for the issuance, development, remediation, and validation of regulator-issued corrective action plans (CAPs) for identified and/or reported issues of non-compliance and effectively represents the business in communication with the regulators regarding such CAPs.
- Works with internal departments in the submission of provider and member materials for the various programs (e.g., marketing collateral, denial letters, provider directories).
- Serves as a critical leader in the review, development, revision, and maintenance of policies and procedures related to the various programs and contracts.
- Prepares updates and reports to management, Board of Directors, and Compliance Committee related to regulatory affairs and related regulatory adherence activities.
- Participates in the development and implementation of process improvements for the organization, particularly those tied to adherence with regulatory requirements.
- Keeps current on the local, state, and federal regulatory environment to identify issues that may impact organization's programs.
- Supports and facilitates the Medicaid/Medicare business development processes for related companies.
- Represents organization at various internal and external meetings.
- Works with all of organization in supporting Magellan departments and functions in response to inquiries, problem-solving, and promoting the company’s mission and message.
- Organizes, leads, and administers a complex project plan for the achievement of regulatory goals and objectives.
- Builds strong regulatory relationships at the state and federal level.
- Translates complex concepts into clear messages for and on behalf of the organization and business leadership.
- Establishes and maintains effective working relationships with all levels of staff and regulatory agencies. Formulates and interprets regulations, policies, and procedures.
- Other accountabilities and duties as assigned.
General Job Information
TitleRegulatory Affairs/Contract Administrator
Job FamilyLegal Group
CountryUnited States of America
FLSA StatusUnited States of America (Exempt)
Recruiting Start Date10/16/2019
Date Requisition Created10/16/2019
Work ExperienceGovernment Affairs, Healthcare, Management/Leadership, Project/Program Management
EducationBachelors: Healthcare (Required), Masters: Healthcare
License and Certifications - Required
License and Certifications - Preferred
Other Job Requirements
- Master’s degree
- Project management/leadership experience
- Bachelor’s degree in a health care related field.
- 7+ years of experience in government or health care in a public or regulatory affairs role.
- Experience in health care, health plans, Medicaid, Long-Term Care; Medicare preferred
- Knowledge of regulatory requirements related to Medicaid, Medicare Advantage, Medicare Part D, Medicare-Medicaid Plans (MMPs) and/or some other equivalent in government programs.
- Proficiency in Microsoft Office applications: Word, Excel, PowerPoint and Visio.
- Communicates effectively, both verbally and in writing, with all levels of staff, other agencies, and stakeholders.
- Possesses exceptional initiative and follow-through on accountabilities and deliverables.
- Ability to translate complex concepts into clear, concise and compelling messages.
- Demonstrates effective team coordination and cooperation and motivates others to do so.
Magellan Health Services is proud to be an Equal Opportunity Employer and a Tobacco-free workplace. EOE/M/F/Vet/Disabled. Every employee must understand, comply and attest to the security responsibilities and security controls unique to their position.
Top 5 reasons to work at Magellan
Meaningful Work With People Who Care
At Magellan Health you can do meaningful work and feel confident that you matter in an organization that makes a real difference in the world - one that cares deeply and uses its employees’ collective insight as a competitive advantage.Read More
We are Compassionately Curious
Magellan Health is a place where we listen with real empathy. It’s one of our biggest strengths. It helps us to support each other and develop innovative solutions for the fastest growing, most complex areas of healthcare.Read More
We are Better Together
We rely on our innate ability to work as a high-functioning collaborative team to facilitate compassionate care to all of our members. With such interdependency comes trust, challenge and innovation.Read More
We believe work and life should flow together in unison. We offer resources that match your professional development, a culture that welcomes your ideas, and unparalleled flexibility to fit work around your life.Read More
Be your best at Magellan Health. We’re a collective of remarkably motivated and driven professionals. As a team, we’re proud of the high standards we set for each other and we’re continually inspired to do our best work.Read More
When you sayLife @ Magellan
To be the best you have to work with the bestWe hear you