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Director Of Government Affairs
The Director of Government Affairs and Compliance is responsible for all aspects of Government Affairs and Affordable Care Act Compliance strategy and operations, including developing and implementing the regulatory strategy and ensuring compliance with applicable laws, policies, and operating procedures for both Wipro HealthPlan Services and its Issuer partners. This individual serves as both an internal and external advisor on regulatory matters to the business and to all relevant functional areas. This person also has oversight of our Affordable Care Act Legal & Compliance teams as well as any audits, contractual and vendor management activities that they are involved in. This position requires a high level of integrity as this person is representing HPS to Issuer counter-parts, as well as to a number of external organizations and Government Affairs agencies (e.g., CMS, AHIP, State DOIs). He / she will mentor and provide guidance to the Government Affairs Specialists and Government Affairs Analysts I and II.
ESSENTIAL JOB FUNCTIONS/DUTIES
- Actively participates in Government Affairs and Compliance -related conference calls, meeting and work groups to ascertain key information discussed; includes in written and verbal Government Affairs and Compliance updates. Serves as a key contact with Government and authorities regarding HealthPlan Services regarding regulatory issues.
- Develop and maintain strong relationships with The Center for Medicare & Medicaid Services, the Federally Funded Marketplace as well as State Based Marketplace regulatory bodies.
- Meeting Participation roles include: Scribe / Presentation, Verbal Q&A, Online Chat, Consolidating and Publishing Meeting Notes, SME Participation, and attending as HPS Key Representative.
- Monitors federal repositories (e.g., ZONE, REGTAP) for recent Government Affairs publications. Maintains necessary Government Affairs -associated subscriptions to conduct its business.
- Analyzes federal regulations and guidance to determine the impact to HealthPlan Services business, as well as to our Issuer partners.
- Develops and presents/communicates internal and external communications regarding assigned regulations / legislation.
- Provision of strategic Government Affairs advice to senior leadership on formal policy interpretations, policy development needs, and potential advocacy and implementation requirements.
- Provides Government Affairs input to crisis and incident management and business continuity planning and events, as required.
- Assists with development of business and IT requirements based on regulation guidelines.
- Provides guidance, information and / or services to various operational areas of HPS to ensure ongoing Government Affairs awareness.
- Supervises, mentors, and provides guidance to Government Affairs Analysts and Government Affairs Specialist.
- Collaboration and / or quality reviews of communications drafted by both State Account Manager and Federal Government Affairs Analysts.
- Actively promotes a culture of compliance and ethical behavior.
- Keeps confidences of the company and individuals.
- Provides research of State and Federal regulations as requested by various operational areas of HPS.
- Partners with Compliance management to ensure all departments are updating regulatory compliance processes within HPS Knowledge Management systems. Consult on compliance adherence monitoring and audits as needed.
- Assists with maintenance of Government Affairs SharePoint site including resource library.
- Other administrative and / or technical duties as deemed necessary.
- Responsibilities impact the achievement of department objectives.
- Drafts, Quality Checks, and Publishes Government Affairs Updates for all topics.
- Owns the Team Charter and Project Objective documents.
- Mentors Team Members to enable ability to advance within Government Affairs.
- Provides support and assistance to individual Team Members.
- Primary backfill to the Team Leader in all functions.
- Backfills the other Team Members as necessary.
- Manages and supervises Team Members.
Years of Experience
- 10+ years’ experience in health insurance operations / IT role with exposure to a broad range of functional areas.
- 5+ years’ experience working at a third-party administrator of fully-insured health insurance or Health Insurance Company.
- Highly detail-oriented.
- Excellent organization and prioritization skills.
- Excellent analytic and problem-solving abilities.
- Ability to effectively communicate verbally and in writing in order to manage projects and tasks, and promote effective communication amount various departments.
- Ability to effectively handle competing priorities.
- Excellent facilitation skills.
- Excellent follow-up & documentation skills.
- Core Competencies
- Ability to understand & follow statutory, regulatory and contractual requirements, verbal instructions, and written policies and procedures.
- Strong interest in, and knowledge of, federal health policy, particularly regarding national healthcare reform and Exchanges.
- Experience interpreting and implementing federal regulations, and experience translating regulations into business requirements, strongly preferred.
- Advanced skills in Microsoft Word, Excel, Outlook, and PowerPoint.
- SharePoint and Microsoft Visio experience is helpful.
- Bachelor’s Degree required. Advanced degrees preferred.
- Comfortable, constant temperatures and absence of objectionable elements.
- Normal degree of physical effort in typical office environment.
- May be subject to frequent interruptions.
- Must be able to shift priorities quickly and handle a diverse set of topics.
- May be subject to frequent business-required travel.
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Job posted: 2022-04-18