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As we empower every New Yorker
to live the healthiest life possible.

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Job Details

Senior State Regulatory Affairs Specialist

Job Ref: 56743
Category: Professional
Department: OFFICE CORPORATE COMPLIANCE
Location: 160 Water St. #3, New York, NY
Job Type: Regular
Employment Type: Full-Time
Hire In Rate: $80,000.00
Salary Range: $80,000.00 - $90,000.00

Marketing Statement

MetroPlus Health Plan provides the highest quality healthcare services to residents of Bronx, Brooklyn, Manhattan, Queens and Staten Island through a comprehensive list of products, including, but not limited to, New York State Medicaid Managed Care, Medicare, Child Health Plus, Exchange, Partnership in Care, MetroPlus Gold, Essential Plan, etc. As a wholly-owned subsidiary of NYC Health + Hospitals, the largest public health system in the United States, MetroPlus’ network includes over 27,000 primary care providers, specialists and participating clinics. For more than 30 years, MetroPlus has been committed to building strong relationships with its members and providers to enable New Yorkers to live their healthiest life. 

Position Overview

Under the direction of the Regulatory Affairs Director, the State Regulatory Affairs Senior Specialist will monitor and ensure compliance with state regulatory requirements by building and maintaining a regulatory guidance infrastructure (including creating and updating of databases and tracking logs). The State Regulatory Affairs Senior
Specialist is responsible for distributing, analyzing and monitoring the implementation of new or updated State regulatory guidance; reviewing materials needing external and internal approval; handling and responding to State audits and surveys; and overseeing regular State reporting requirements.

Job Description

  • Monitor, distribute, interpret and analyze new laws, regulations and guidance applicable to specified business units. Work with business units to assess potential impact.
  • Monitor changes to regulatory requirements and work with business units to identify changes needed to mitigate risks and achieve compliance. Work with business units to ensure implementation is complete and meets the regulatory requirement.
  • Complete timely research for regulatory questions on department processes, policies and procedures, or materials for applicable business units.
  • Review materials sent to external regulatory agencies.
  • Assist with external regulatory audits, surveys and regulatory reporting.
  • Support other regulatory compliance related activities as needed.
  • Provides explanations and information to others on regulatory issues and requirements. 
  • Works to ensure knowledge of State Sponsored products is up to date.
  • Collaborates with Compliance team on the Annual Risk Assessment and Work Plan.  Reviews and updates all related training materials.  
  • Prioritizes and organizes own work to meet deadlines.

Minimum Qualifications

  • Bachelor's degree with 6+ years equivalent Regulatory Affairs work experience; Master’s
  • Degree or JD preferred.
  • Experience with State Exchange products strongly preferred.
  • 5+ years of experience with MS Word, Excel and PowerPoint required.
  • Experience in a position requiring independent judgment and initiative.
  • Excellent interpersonal and communication skills (both verbal and written) required
  • Ability to meet deadlines, multi-task, problem solve and use appropriate technology to analyze
  • business problems. Project management skills a plus.

Professional Competencies

  • Integrity and Trust
  • Customer Focus
  • Functional/Technical skills
  • Strong Written/Oral Communication