Regulatory Affairs Director - Hybrid

Job description

Job Summary: The Regulatory Affairs Director is responsible for leading activities of the Regulatory Affairs Department, including contracts, compliance, surveys, audits, investigations, reporting, plan development and renewal, credentialing, Fraud, Waste & Abuse Special Investigations, provider network and relations, regulatory updates and compliance matters. Essential Functions: - Review, draft, negotiate and process agreements and amendments in accordance with organization guidelines. - Lead projects involving the collection and submission of data and information related to government audits, surveys and requests. - Oversee provider contracting, including letters of agreement and associated follow-up. - Review, disseminate and handle fair hearing (FH) notices and decisions; manage FH calendar; attend FHs as needed, review and handle communications with OTDA and submit reports; prepare status reports and updates on cases. - Lead activities of the Special Investigation Unit (SIU), including SIU reporting and internal investigations. - Review and update applicable HIPAA policies and procedures in compliance with HIPAA laws and regulations. - Review OIG/OMIG requirements and best pr...