Required: Bachelor's degree in Healthcare Administration, Public Health, Business Administration, Law, or related field.
Minimum of 10 years of progressive experience in healthcare compliance, managed care operations, regulatory affairs, auditing, or related healthcare functions.
Minimum of 5 years of leadership experience managing managers, Directors, or multidisciplinary teams.
Extensive knowledge of Medicare Advantage, Medicaid Managed Care, MLTC, integrated healthcare products, and New York State healthcare regulations.
Demonstrated experience managing external regulatory audits, compliance investigations, corrective action plans, and regulatory implementation programs.
Strong knowledge of CMS, New York State Department of Health, OIG guidance, and managed care regulatory requirements.
Experience overseeing complex compliance programs