Regulatory Affairs Specialist, South San Francisco, CA
REGULATORY AFFAIRS SPECIALIST
The Health Plan of San Mateo (HPSM), a managed care health plan, seeks a full time Regulatory Affairs Specialist who will identify and analyze new legislation, regulations and contractual requirements. Submit reports and work plans to enable required changes in HPSM operations. Works with the Chief Compliance Officer and CEO to develop and support advocacy efforts with state and federal officials.
The essential duties and responsibilities will include the following:
- Research regulations, laws and contractual requirements and determine applicability to HPSM, its staff, policies and vendors.
- Conduct impact analysis to determine need for immediate intervention by senior management.
- Develop work plans identifying tasks, deliverables, assignments to business owners and due dates to ensure timely compliance with new requirements.
- Track completion of assigned tasks by collaborating with business owners and/or project management.
- Develop validation protocols and guidance for internal auditors to verify compliance with new regulations has been achieved
- Attend and participate in the HPSM Operations Committee.
- Co-develop and assist with implementation of strategic advocacy plans for educating state and federal policy makers.
- Work with HPSM legislative representatives to develop new legislative initiatives, as needed.
- Remain informed about health care policy in Medicare, Medicaid, insurance, long term care, and mental health for vulnerable populations.
- Provide high level staff work in policy development and implementation in the areas of Medicare, Medi-Cal, other insurance programs, long term care, mental health and other health-related programs as assigned.
- Perform other duties as assigned
Education and Experience: Bachelor’s Degree in Healthcare, Health Administration, Business Administration or related discipline. Related and relevant experience may be considered in lieu of academic requirements on a year for year basis. Minimum of two (2) years of related experience in healthcare industry with managed care experience preferred. Experience with project management development of work flows and other project management tools.
Knowledge of: Personal computers and proficiency in Microsoft Office Suite applications, including Outlook, Word, Excel, Access and PowerPoint. Managed care and strong familiarity with the health care field. Regulatory and or compliance processes impacting managed health care. Principles and practices of managed care health care systems, medical administration and NCQA accreditation standards. State and federal legislative process. Medicare and Medi-Cal programs. Policy development.
Ability to: Work cooperatively with others. Work as part of a team and support team decisions.
Communicate effectively, both verbally and in writing. Adapt to changes in requirements/priorities for daily and specialized tasks. Display professional communication skills (both written and oral) and possess a high level of attention to detail. Demonstrate superior organization, facilitation, and presentation skills.
Build and maintain strong relationships within and outside HPSM. Impart critical thinking, listening, time management, decision making, and problem solving skills; maintain confidentiality. Think and work effectively under pressure and accurately complete tasks within established times; prioritization and meeting critical deadlines. Work independently and within a team environment as well as work collaboratively across functional areas in a matrix structure. Effectively train and provide customer service skills in accordance to various audiences and comprehension levels. Exhibit strong interpersonal skills to utilize when coaching staff and handling conflict resolution. Work collaboratively and effectively with HPSM staff, as well as representatives of federal, state, and county organizations. Perform policy analysis, development and implementation in the areas of Medicare, Medi-Cal, other insurance programs, long term care, mental health and other health-related programs. Analyze legislation and regulations that impact HPSM operations. Conduct research and analysis to support decision-making and planning for major strategic initiatives. Advocate for the organization; coordinate efforts to educate state and federal policy makers; work with HPSM’s legislative representatives. Deal tactfully and effectively with HPSM members and staff, the public, members of the legislature, and governmental representatives.
Compensation and Benefits
Starting Compensation Range: - Depending on Experience
Benefits Information: Excellent benefits package offered, including HPSM paid premiums for employee’s Medical, Dental and Vision coverage. Employee pays a small portion of the dependent premiums (5%) for medical and dental benefits. Additional HPSM benefits include fully paid life, AD&D, and LTD insurance; retirement plan (HPSM contributes equivalent of 10% of annual compensation); holiday and vacation pay; tuition reimbursement plan; onsite fitness center and more.
How to Apply
Application Process: To apply, submit a resume and cover letter with salary expectations to: Health Plan of San Mateo, Human Resources Department, 801 Gateway Blvd., Suite 100, South San Francisco, CA 94080 or via email: firstname.lastname@example.org or via fax: (650) 616-8039. File by: Continuous until filled. The Health Plan of San Mateo is proud to be an Equal Opportunity Employer and encourages minority candidates of all backgrounds to apply.
Submissions without a Cover Letter and Salary Expectations may not be considered.