MLTC-AVP of Regulatory Affair
: Job Details :

Overview:

RiverSpring Health Plans serves over 16,000 frail individuals and help them live in their homes and independently for as long as possible. Join our compassionate and dedicated team and make a difference in the lives of our membersat RiverSpring Health Plans. The AVP of Regulatory Affairs will be responsible for the planning, developing, directing, delivering, evaluating, and coordinating activities of the Regulatory Affairs Department.

Responsibilities:

The AVP in collaboration with senior management will be responsible to review, draft, negotiate and process agreements and amendments in accordance with regulatory requirements and plan guidelines; manage projects including plan development, the collection and submission of data and information and provider communication related to audits, surveys, requests and regulatory requirements; draft and update policies and procedures in compliance with laws and regulations; conduct security breach investigations and prepare breach reporting; review OIG and OMIG requirements and best practices for compliance program; review and update compliance materials, including manuals, policies and procedures, handbooks, to comply with regulatory requirements; make recommendations based on best practices; provide oversight and supervision of the Departments staff.

Qualifications:

Juris Doctorate and current New York State Law License in good standing required. Minimum 5 years experience in practicing law, with emphasis in managed care contracting, credentialing and compliance. MLTC, MAP and Medicaid/Medicare knowledge required. Commensurate supervisory experience required. Ability to respond to inquiries or complaints from members, providers, regulatory agencies, staff or members of the business community. Ability to write articles for publication that conform to prescribed style and format. Ability to effectively present information to top management, public groups, and/or boards of directors.

Compensation: $185,000 - $200,000 Annually

Our staff are our greatest asset and as such we offer an excellent and comprehensive benefits package which includes:

HEALTH & INSURANCE BENEFITS*

Medical and Prescription DrugCompany-Paid DentalCompany-Paid VisionCompany-Paid Life Insurance and Accidental Death & DismembermentCompany-Paid Short-Term DisabilityCompany-Paid Long-Term DisabilityHealth Care Flexible Spending AccountDependent Care Flexible Spending AccountEmployee Assistance PlanAdditional Life Insurance options for the employee and family membersAdditional Disability options403(b) Plan, with a generous employer contributionTIME OFF BENEFITS*HolidaysPersonal DaysSick DaysVacation

ADDITIONAL BENEFITS*Bereavement DaysCell Phone Discount PlanCommuter PlanJury Duty DaysMarriage DaysPet Insurance Discount PlanTuition AssistanceWellness ProgramsYears of Service Awards

*This information is subject to change and it is not meant to be a comprehensive explanation of our employee benefits. The benefits contained in this benefit summary could change at any time without notice.

EOE