Sr. Mgr, Payor Relations, Regulatory Affairs

Sr. Manager, Payor Relations and Regulatory Affairs Accordance Search Group  Livermore, California, United States (On-site)
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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.

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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.

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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.

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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

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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