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

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