Director of Federal and Integrated Regulatory Guidance – Remote / NYC
Location: Remote with occasional in-office presence in NYC for key meetings
Salary: Up to $160,000 + excellent benefits
A Managed Care organization in Manhattan is seeking a Director of Federal and Integrated Regulatory Guidance to lead a team of regulatory professionals responsible for analyzing new regulatory requirements, supporting business teams in understanding compliance obligations, and ensuring adherence to federal and state regulations. This position plays a key leadership role in overseeing compliance for Managed Long-Term Care (MLTC), Medicaid Advantage Plus (MAP), Medicare Advantage, and Medicare D-SNP products.
This is an exciting opportunity to join a growing organization with a strong mission and a competitive compensation and benefits package.
Director of Federal and Integrated Regulatory Guidance – Key Responsibilities
Lead and manage a team responsible for interpreting and analyzing new federal and state regulations affecting Medicare and Medicaid plans.
Ensure the organization remains compliant with all regulatory requirements by proactively communicating updates and changes across departments.
Work closely with leadership to assess regulatory risks, develop compliance strategies, and align business operations with evolving legal requirements.
Establish and maintain strong relationships with regulatory agencies, participating in stakeholder calls and industry discussions to stay informed on policy changes.
Collaborate with internal teams, including Compliance, Legal, and Operations, to ensure regulatory obligations are met.
Provide regulatory support and guidance to business units, ensuring they understand new policies, compliance expectations, and potential business impacts.
Oversee regulatory filings, reports, and documentation in coordination with the Regulatory Operations team.
Participate in high-level initiatives, such as vendor transitions, carve-in/carve-out services, and program expansions.
Assist with external audits and surveys, including CMS Program Audits, and work with internal teams to ensure preparedness and compliance.
Supervise and mentor Regulatory Analysts, providing guidance, assigning tasks, and conducting performance evaluations.
Support ongoing process improvements in communication and compliance strategies within the organization.
Director of Federal and Integrated Regulatory Guidance – Qualifications
Bachelor’s degree required.
Minimum 7 years of experience working with Medicare and Medicaid laws and regulations, ideally in a leadership role within a managed care compliance or regulatory department.
In-depth knowledge of healthcare law, policy application, and managed care regulations.
Strong experience in regulatory analysis, risk assessment, and compliance program development.
Proven ability to build relationships with regulatory agencies, stakeholders, and cross-functional teams.
Excellent leadership, strategic thinking, and problem-solving skills.
Strong communication and presentation abilities, with experience in preparing reports, policy summaries, and stakeholder updates.
Experience supervising staff and overseeing regulatory projects.
Familiarity with legal research applications (e.g., LexisNexis) is a plus.
Director of Federal and Integrated Regulatory Guidance – Professional Competencies
Strategic Thinking & Decision Making – Ability to anticipate policy changes and guide the organization in adapting to new regulations.
Collaboration & Leadership – Effective at working across teams, mentoring staff, and influencing key business decisions.
Regulatory Expertise & Risk Management – Proactive in identifying compliance risks and ensuring adherence to evolving healthcare regulations.
Communication & Stakeholder Engagement – Skilled in articulating complex regulatory information to diverse audiences, including senior leadership.
This Director of Federal and Integrated Regulatory Guidance role offers a competitive salary of up to $160,000, along with excellent benefits.
RCM Health Care Services
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