Sr. Manager, Payor Relations and Regulatory Compliance Job at Accordance Search Group, Livermore, CA

R1JzbmNCdEplVm9iTHlVQjMyRlhiMmJ1Rmc9PQ==
  • Accordance Search Group
  • Livermore, CA

Job Description

Our client is in search of a Senior Manager, Payor Relations and Regulatory Affairs. The position is located on-site in Livermore, California for a Fortune 500 medical device company.

This position provides regulatory compliance leadership for the business, ensuring the policies, procedures, and practices of the business remain compliant to regulatory and contract requirements.

What You’ll Work On

  • Directly manages team responsible for following: CMS enrollment, Medicaid enrollment, state licenses, Joint Commission accreditation, payor contract review, and quality systems
  • Develops and participates in setting compliance strategies and initiatives.
  • Oversees business policies, processes and programs to ensure business remains compliant to regulatory and contract requirements
  • In charge of audits and regulatory inspections.
  • Responsible for ensuring business licenses are up to date and compliant with all geographies the business operates within
  • Provides oversight to the complaint management process and reporting requirements
  • Leads organization through all activities required to maintain Joint Commission accreditation
  • Monitors relevant regulations for changes applicable to business and ensure policies and procedures are updated as needed
  • Ensure timely processing of sales contracts and Medicaid enrollments
  • Negotiate and draft high-value complex contract terms and conditions in accordance with corporate policies
  • Acts as a Contract Administration lead and be able to train new hires
  • Analyze potential risks that contract changes may pose to the organization and provide solution
  • Present and explain contract conditions and details to customers, business partners, and management
  • Work with different levels of personnel within an organization to analyze and solidify an overall contract strategy
  • Interface with internal fulfillment group and distributors to establish working relationships, assure proper end-user pricing and contract effective dates are loaded
  • Perform other duties & projects as assigned.
  • Understands and is aware of the quality consequences which may occur from the improper performance of their specific job.

Required Qualifications

  • Demonstrated ability of effective and constructive communication across departmental disciplines while pursuing contract department goals.
  • Experience and competency with EMR systems, Government and Insurance Portals
  • Must have excellent oral, written and interpersonal communication skills
  • Must have customer service attitude & good computer skills (Microsoft Word, Excel, Outlook, etc.)
  • Self-starter and a multi-tasker
  • Ability to work in a high volume, dynamic team environment

Preferred Qualifications

  • 10+ years of relevant experience
  • Bachelor's degree or equivalent experience
  • Experience with regulations pertaining to being a service provider for durable medical equipment (DME) and/or an independent diagnostic test facility (IDTF) strongly preferred

Job Tags

Contract work,

Similar Jobs

Mellott

Product Support-Inside Sales Job at Mellott

 ...Product Support - Inside Sales Full Time Warfordsburg, PA, US Job Scope: Speak to clients on the phone highlighting salable...  ...incoming calls for replacement parts for aggregate related equipment Compile lists of prospective customers for use as sales leads... 

Affinity Management Services LLC

Regional Director Job at Affinity Management Services LLC

 ...Valid Driver's License. Required Education and Experience: ~ Associate's degree required (preferred concentration in Business, Real Estate, and/or Hospitality). ~4+ years of Community Association Management and/or business experience with increasing levels of... 

Inflection Point Entertainment

Podcast Project Manager Job at Inflection Point Entertainment

&##128680; We're Hiring: Podcast Project Manager (Remote / Part-Time) &##128680; &##127911; Independent Production Company | &##1281...  ...creating compelling audio and visual content. We are currently producing a weekly podcast that blends insightful conversation with... 

YMCA of the USA

Early Education Director - Amesbury YMCA Job at YMCA of the USA

 ...beautiful new Amesbury Childcare Center may be the perfect fit for you! About The Role As the Early Learning Director at the Amesbury YMCA, you will lead and support a team of passionate educators to provide exceptional care and learning experiences for infants, toddlers... 

Workforce Solutions sourcing candidates for a hospital in th...

Intensive Care Nurse Job at Workforce Solutions sourcing candidates for a hospital in th...

Benefits options: $56.35 Base Hourly Rate $4.93 Health & Welfare Hourly Rate (all paid hours up to 40 per week) Company Matching 401k 11 Paid Legal Holidays Sick Time & Vacation Medical Dental Vision Extended Sick Leave Intensive Care Registered...