Large Managed care organization with offices around NYC, is currently seeking an experienced Director of Regulatory Affairs for their Bronx, NY office. This role does require a JD (Juris Doctor) and is comes with a Hybrid work schedule. This role also comes with a very competitive salary and benefits package. Please apply for more info. 

Director of Regulatory Affairs – MLTC (Hybrid)

The Director of Regulatory Affairs is a senior leadership role responsible for the development, implementation, and oversight of regulatory compliance activities across the Health Plans. This individual works closely with senior leadership to ensure compliance with all applicable laws and regulations, including CMS, DOH, OIG, and OMIG requirements.

Key Responsibilities

• Review, negotiate, and process contracts, agreements, and amendments to ensure alignment with internal protocols and regulatory standards.
• Draft, update, and maintain policies, procedures, manuals, and member handbooks in accordance with state and federal requirements.
• Prepare, submit, and manage timely regulatory filings and reports.
• Direct and oversee provider communication regarding audits, surveys, and regulatory inquiries.
• Disseminate and provide guidance on CMS and DOH memos, alerts, and updates.
• Lead and coordinate activities related to the Special Investigations Unit (SIU), including fraud, waste, and abuse (FWA) investigations.
• Review and implement best practices related to OIG and OMIG compliance guidelines.
• Provide oversight, supervision, and development of department staff.
• Collaborate with internal departments and external partners to promote regulatory readiness and ensure audit preparedness.

Qualifications

• Juris Doctor (JD) degree required.
• Minimum of 5 years’ experience in regulatory affairs, managed care compliance, or healthcare law, with emphasis on contracting, credentialing, and compliance.
• Demonstrated supervisory and leadership experience.
• Strong understanding of CMS, DOH, OIG, and OMIG regulations.
• Excellent communication skills with the ability to interact effectively with members, providers, staff, and regulatory agencies.
• Proven ability to manage projects, meet deadlines, and work cross-functionally with executive leadership.

Compensation: 

• $170,000 – $180,000 annually
• Benefits include health insurance, retirement plans, paid time off, and professional development opportunities.