Healthfirst

The Regulatory Manager will work collaboratively with key internal staff on the development, review and submission of regulatory filings, reports and other material as required. The incumbent will provide support to the Director by ensuring, cultivating and advancing an environment that not only enhances and promotes compliance and adherence to the company's ethical standards; but that also conforms to all relevant federal, state and local laws, rules and regulations that pertain to Healthfirst's commercial insurance products.

Duties & Responsibilities: Coordinates and leads the development, preparation, and submission of regulatory reports and filing materials, including but not limited to, product Rate & Form filings, and correspondence with various federal and state regulatory bodies. Serves as Subject Matter Expert on New York State commercial health insurance regulations, laws and market dynamics. Works with appropriate business units to ensure timely review of submission materials and execution of necessary production revisions and changes. Researches, interprets, and communicates regulatory requirements for operational units to ensure compliance with federal and/or state requirements.  Recommends and/or facilitates the required steps to effectuate necessary changes. Works in conjunction with appropriate departments to ensure newly enacted regulatory and statutory requirements are implemented within mandated time frames. Reviews and approves policies and procedures to ensure regulatory requirements are met. Reviews applicable company correspondence and marketing materials to ensure compliance with relevant regulatory requirements. Consults with internal departments regarding regulatory issues while understanding the underlying root cause and applicable regulatory requirements, conducts analysis of risk, and recommends or initiates necessary corrective action. Serves as a point of contact for federal and state regulatory agencies on day-to-day issues. Responds to inquiries on regulatory issues. May represent the Regulatory Affairs department on committees and special projects. Supplies guidance to appropriate departments regarding the ongoing development and maintenance of the corporate web site. Ensures that any new federal and/or state requirements are implemented within required time frames. Provides support to all internal stakeholders, as needed, to assist with meeting various project deadlines and objectives. Identifies potential risk areas and develops or facilitates corrective actions to ensure continuing compliance. In collaboration with the Healthfirst Compliance department, oversees implementation and effectuation of all plans of correction developed for both internal and external audits. Works in collaboration with the Regulatory Audit Manager on all external agency audits/site visits, as necessary. Manages the company’s processes related to out-of-network surprise bill independent dispute resolution cases.

Hiring Range*: Greater New York City Area (NY, NJ, CT residents): $98,400 - $142,205 All Other Locations (within approved locations): $84,400 - $125,545 As a candidate for this position, your salary and related elements of compensation will be contingent upon your work experience, education, licenses and certifications, and any other factors Healthfirst deems pertinent to the hiring decision. In addition to your salary, Healthfirst offers employees a full range of benefits such as, medical, dental and vision coverage, incentive and recognition programs, life insurance, and 401k contributions (all benefits are subject to eligibility requirements). Healthfirst believes in providing a competitive compensation and benefits package wherever its employees work and live. *The hiring range is defined as the lowest and highest salaries that Healthfirst in “good faith” would pay to a new hire, or for a job promotion, or transfer into this role.

WE ARE AN EQUAL OPPORTUNITY EMPLOYER. Applicants and employees are considered for positions and are evaluated without regard to mental or physical disability, race, color, religion, gender, gender identity, sexual orientation, national origin, age, genetic information, military or veteran status, marital status, mental or physical disability or any other protected Federal, State/Province or Local status unrelated to the performance of the work involved.