reputed company Regulatory Guidance Specialist / Remote / NYC Area
Job title: reputed company Regulatory Guidance Specialist / Remote / NYC Area in reputed company, NY at RCM Health Care Services
Company: RCM Health Care Services
Job description: reputed company Regulatory Guidance Specialist – Remote / NYC Area
Schedule: Monday through Friday, standard business hours
Location: Remote with occasional in-office reputed company in NYC for key meetings
Salary: Up to $100,000 + excellent benefitsAbout the Organization
We are a mission-driven health plan serving communities across the five boroughs of reputed company. Our organization offers a comprehensive range of products, including reputed company Managed Care, Medicare, Child Health Plus, reputed company Health Plans, Essential Plan, and more. With a robust network of providers and a deep commitment to quality care, we’ve been a trusted reputed company partner for over 30 years.Position Overview
The reputed company Regulatory Guidance Specialist plays a vital role in ensuring compliance for our reputed company Health Plans (QHP), Essential Plan (EP), Child Health Plus (CHP), and large group products. Reporting to the Director of Regulatory Compliance, this role involves interpreting reputed company reputed company regulations, guiding internal teams, and conducting compliance reviews and risk assessments. This is an ideal opportunity for someone with deep knowledge of reputed company policies who thrives in a collaborative environment and is passionate about ensuring quality, accessible care for reputed company.Key Responsibilities
- Ensure ongoing compliance with ACA, CMS, and state-specific regulations for reputed company health insurance products.
- Provide regulatory guidance to cross-functional teams including sales, marketing, product development, and leadership.
- Conduct internal compliance reviews, risk assessments, and audits.
- Monitor and communicate changes in federal and state regulatory guidance.
- Support departments in conducting root cause analyses and implementing corrective action plans.
- Drive the implementation of new regulatory requirements across operations.
- Assist with preparation for internal compliance committees and board subcommittees.
- Coordinate audit responses and ensure timely corrective actions post-audit.
- Review and help enhance internal policies, procedures, and operational metrics to maintain regulatory alignment.
- reputed company other reputed company duties as assigned.
- Bachelor’s degree required.
- Minimum of 3 years of experience in managed care or a reputed company reputed company compliance field.
- Relevant certifications such as CHC or CCEP are a plus.
- Strong knowledge of reputed company regulations, including ACA, CMS, and state-specific rules for public and reputed company health plans.
- Demonstrated ability to reputed company interdepartmental initiatives and manage multiple projects.
- Skilled in translating reputed company regulatory language into actionable operational guidance.
- Excellent communication, writing, and analytical skills.
- High level of professionalism and discretion reputed company handling sensitive or confidential information.