Director Compliance & Regulatory Affairs

09 Oct, 2020

Jobs

Director Compliance & Regulatory Affairs

Amerihealth Caritas
Southfield, MI

Your career starts now. We’re looking for the next generation of health care leaders.

At AmeriHealth Caritas, we’re passionate about helping people get care, stay well and build healthy communities. As one of the nation’s leaders in health care solutions, we offer our associates the opportunity to impact the lives of millions of people through our national footprint of products, services and award-winning programs. AmeriHealth Caritas is seeking talented, passionate individuals to join our team. Together we can build healthier communities. If you want to make a difference, we’d like to hear from you.

Headquartered in Philadelphia, AmeriHealth Caritas is a mission-driven organization with more than 30 years of experience. We deliver comprehensive, outcomes-driven care to those who need it most. We offer integrated managed care products, pharmaceutical benefit management and specialty pharmacy services, behavioral health services, and other administrative services. Discover more about us at www.amerihealthcaritas.com.

Responsibilities:

Under the general direction of the Executive Director, the Director, Compliance and Regulatory Affairs provides strategic advice and guidance for achieving ACFC goals and objectives while complying with contract requirements and Medicaid regulations for both physical health and behavioral health managed care business.  He/she is responsible for the development and implementation of a Compliance Program for physical health managed care business to ensure compliance with key business requirements and to minimize risk issues. He/she also provides strategic guidance to the implementation of policy and initiatives in response to emerging federal health care policy.

The Director, Compliance and Regulatory Affairs, manages the annual D.H.H. contract amendment process, facilitating timely review and comment and maintaining appropriate change control procedures.

The Director, Compliance and Regulatory Affairs assist the Executive Director with the development and execution of departmental strategic planning and budget activities.  He/she directs the administrative functions for the Government Affairs Office and provides information and recommendations to the Executive Director on matters that may impact departmental goals and the budget.  He/she directly manages a team of professional associates and supports the development of highly skilled and knowledgeable associates.  He/she represents the Executive Director in his/her absence.

The ­­­­­­­­­­­­­­­­­­ Director, Compliance and Regulatory Affairs operates independently with minimal management oversight, and is able to manage competing priorities and deadlines that are subject to frequent change.  He/she must possess and exercise excellent professional judgment in all interactions.

Education/ Experience:

  • Bachelor’s Degree.
  • 5 plus years management exp in healthcare/insurance, preferably in Medicaid Managed Care.

Learn more here

Job posted: 2020-10-09