Director, Regulatory Operations

Position Purpose: Direct and oversee regulatory compliance operations to ensure fully compliance with all applicable laws and regulations for assigned products/services. Key Details : The role is fully remote. Must be authorized to work in the U.S. without the need for employment-based visa sponsorship now or in the future. Sponsorship and future sponsorship are not available for this opportunity, including employment-based visa types H-1B, L-1, O-1, H-1B1, F-1, J-1, OPT, or CPT. Oversee, administer, and implement various aspects of the Ambetter Regulatory Operations program, including regulatory complaints, complaint escalations and grievance support. Ability to research and apply CMS, DOI, OIG, and HIPPA regulations to create processes and strategies while ensuring corporate compliance. Coordinate and document Centene responses to CMS/Regulator Request for Information/Response. Provide guidance to various departments regarding compliance/regulatory issues and ensure implementation of new compliance requirements with respect to regulatory and contract language. Identify, evaluate and analyze the impact of CMS and Marketplace regulatory issues and advise management concerning impact. Partner with various departments to ensure that state and/or federal regulatory requirements are communicated and met. Maintain and track laws and regulations, contract documentations, amendments, and various compliance measures. Ensure all Marketplace products and services are being tested for c