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Regulatory Affairs AssociateAdvisory and Consulting Services • Bronx, NY
Regulatory Affairs Associate

Regulatory Affairs Associate

Advisory and Consulting Services • Bronx, NY
30+ days ago
Job type
  • Permanent
Job description

Regulatory Affairs Associate – Managed Long Term Care (MLTC)

Compensation: $150K–$170K per year

Job Type: Monday through Friday, 9:00 AM to 5:00 PM. This role will be fully onsite for the first 90 days during the probationary period. After that, the position transitions to a hybrid schedule: 3 days in the office and 2 days remote.

Our client, is seeking a Regulatory Affairs Associate to support and coordinate compliance activities within its health plan operations. This position plays a critical role in ensuring regulatory alignment across various programs, contracts, and legal matters, including CMS, DOH, OIG, and OMIG compliance.

Responsibilities

  • Draft, review, and negotiate provider and organizational agreements in accordance with internal policies and compliance standards.
  • Lead and manage data collection and submissions for external audits, surveys, and government requests.
  • Oversee provider contracting processes and manage follow-up communications.
  • Administer Fair Hearing (FH) cases, including calendar management, case prep, documentation, and hearing attendance.
  • Handle regulatory reports and provide updates on ongoing cases and investigations.
  • Participate in Special Investigation Unit (SIU) functions, including compliance reporting and internal investigations.
  • Update HIPAA-related policies and procedures to ensure compliance with current regulations.
  • Maintain awareness of and ensure adherence to OIG and OMIG compliance practices and requirements.
  • Review state and federal plan contracts to ensure consistency with regulatory standards.
  • Distribute and interpret CMS and DOH updates, memos, and official regulatory guidance.
  • Coordinate document production in response to legal matters or litigation requests.
  • Maintain internal databases related to provider credentials and other compliance documentation.
  • Draft and revise internal policies, procedures, manuals, and member-facing plan materials.
  • Supervise and provide oversight to department support staff.

Requirements

  • Juris Doctor (JD) from an accredited institution
  • Must be a Licensed Attorney
  • Minimum of 3 years’ experience in managed care compliance, credentialing, or contracting
  • Familiarity with MLTC, MAP, Medicaid, Medicare program regulations
  • Demonstrated leadership or supervisory experience
  • Strong legal and analytical skills related to contract review and compliance oversight
  • Proven ability to handle investigations and recommend practical solutions

Benefits

  • Medical
  • Dental
  • Vision
  • 403B with employer match
  • Life insurance
  • Flexible Spending Account
  • Employee Assistance Program (EAP)
  • Pet insurance
  • Tuition Reimbursement Program
  • PTO
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Regulatory Affairs Associate • Bronx, NY

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