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Manager Legislative and Regulatory Affairs - SHP

Job ID: 103551 Date posted: July 17, 2020

  • Sharp HealthPlan
  • Operations
  • Management Jobs
  • Day Job
  • Full-Time

Responsibilities

Summary

This Excellent opportunity will be responsible for providing effective leadership for Sharp Health Plan in the areas of: federal and state legislative and regulatory analysis and implementation, regulatory affairs, and government relations for the Plan’s commercial and government lines of business. Responsible for identifying, tracking and conducting wide scope analyses of legislative and regulatory issues affecting Sharp Health Plan and advising senior leadership concerning their impact. Develops reports and makes recommendations based on this information. Develops approach and methodology for implementing new legislative and regulatory requirements, directs the development of comprehensive and detailed project plans, and oversees project execution. Represents and serves as point person for Sharp Health Plan to outside trade groups/stakeholders, including, but not limited to, the California Association of Health Plans (CAHP) and America’s Health Insurance Plans (AHIP).

In collaboration with the Director of Compliance and Regulatory Affairs, advocates on behalf of Sharp Health Plan with outside trade groups/stakeholders and state and federal regulatory agencies. Cultivates positive relationships with regulators, including, but not limited to, the Center for Medicare & Medicaid Services (CMS) and the California Department of Managed Health Care (DMHC). In coordination with the Director of Compliance and Regulatory Affairs and the Compliance Officer, responds to inquiries from the CMS, the DMHC, and other regulatory bodies. Manages and participates in regulatory filings and reports, ensuring timely and accurate submissions. Develops and maintains subject matter expertise on legislative, regulatory and contractual issues affecting commercial and Medicare health plans in California. Promotes the satisfaction, development and productivity of department staff. Participates as a part of, and in support of, a management team that works collaboratively to ensure the success of Sharp Health Plan’s goals, objectives, and strategic initiatives.

This might be the job for you if you are:

  • A self-starter who has a knack for implementing order and processes
  • Someone who thrives in fast-paced environments with multiple deadlines and deliverables
  • An excellent communicator (verbal and written)
  • Someone who can turn ambiguity into action
  • Good at creative problem solving and decision-making
  • Someone who possesses an eye for detail
  • A team player who can effectively manage up and across an organization
  • Good at working with cross-functional teams

If you like the sound of what it means to be a Sharp Health Plan team member, and you meet the qualifications above, please submit your resume along with a brief explanation about why you would be a good fit for this position. We look forward to hearing from you!

Sharp Health Plan is the largest, locally-based commercial health plan in San Diego. We are a not-for-profit organization serving the needs of San Diegans since 1992. As a subsidiary of Sharp HealthCare, San Diego’s largest provider of health care services, we not only serve the people of San Diego, we are the people of San Diego.

Through our unique integration with Sharp HealthCare, we connect our members to an award-winning network of hospitals, medical groups and physicians. We offer health insurance options for individuals, families, groups and businesses that combine affordability, choice, high-quality health care and personal service.


Location

This position is located in Kearny Mesa, San Diego County

 

Hours

8-hour Day shift: weekends as needed.

 

Required Skills and Qualifications

 

  • Undergraduate degree in political science, public policy, business, law, health care administration or related field.
  • Three (3) years of experience in health care policy, legislative or regulatory affairs/advocacy, and/or managed care compliance or operations.
  • Three (3) years’ experience in position requiring high levels of cooperation and collaboration.
  • Knowledge of state and federal laws and regulations governing health plans.
  • Experience managing large scope, complex projects, including planning and developing comprehensive project plans, project execution, risk and issue management, and project performance reporting.
  • Experience conducting research, thorough analysis, interpretation of findings and preparing concise, accurate reports.
  • Strong leadership and management skills with ability to supervise, motivate and coach staff.
  • High level of integrity; ability to exercise sound judgement and maintain confidentiality.
  • Excellent diplomacy skills to effectively lead advocacy efforts and resolve issues.
  • Strong analytical skills and attention to detail.
  • Readily adaptable to the changing needs of the business and demonstrated ability to effectively manage multiple priorities.
  • Tolerance for ambiguity.
  • Exceptional planning, communication (both verbal and written), time management, organizational and follow-through skills with a strong sense of urgency in a fast-paced environment.
  • Demonstrated ability to prepare and present information in a clear and concise manner and formulate recommendations.
  • Ability to represent Sharp Health Plan effectively internally and externally in dealings with peers, executives, legislators, regulators, consultants, vendors or other parties.
  • Working knowledge of and the ability to operate applicable computer software efficiently, including a working knowledge of computer applications such as electronic mail software and Microsoft Office Suite.
  • Ability to use a keyboard with moderate speed and a high level of accuracy.

 

Preferred Skills and Qualifications

 

  • Master’s degree in political science, public policy, business, law, health care administration or related field, or Juris Doctor
  • Three (3) years of experience in a leadership role, ideally involving legislative and/or regulatory affairs.
  • Experience with legislative and regulatory issues affecting commercial health care service plans in California.
  • Experience with Medicare Part C and D legislative and regulatory affairs.
  • Thorough understanding of health care delivery models, health care benefits and health plan operations.
  • Experience using project management tools/software.
Sharp HealthCare is an equal opportunity/affirmative action employer. All qualified applicants will receive consideration for employment without regard to race, religion, color, national origin, gender, gender identity, sexual orientation, age, status as a protected veteran, among other things, or status as a qualified individual with disability

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“After nearly 10 years of working here, it's still one of the hardest jobs I've ever loved. If you find a niche here, you'll be working with some of the smartest in the industry. This is where they'll respect you for thinking outside the box and kindness matters. They expect consistency and hard work, but pay you well to do it.”

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