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Accordance Search Group · 1 month ago

Sr. Manager, Payor Relations and Regulatory Compliance

Livermore, CA

Full-time

Onsite

Senior Level

7+ years exp

Accordance Search Group is representing a Fortune 500 medical device company seeking a Senior Manager for Payor Relations and Regulatory Affairs. This role involves leading payor relations and regulatory affairs to ensure compliance and drive innovation within the business unit.

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Hiring Manager

Kathy Lane

Responsibilities

Directly manages team responsible for following: payor contract negotiation, payor contract implementation, payor contract monitoring, Medicare/Medicaid enrollment, state licensing, and Joint Commission accreditation

Negotiates, drafts, implements, and monitors commercial contracts across major US-based health plans, in accordance with corporate policies and regulatory requirements

Leads organization through all activities required to maintain Joint Commission accreditation, including audits & inspections

Responsible for ensuring business licenses are up to date and compliant with all geographies the business operates within

Leads business-wide contracting governance processes in collaboration with Revenue Cycle Management, Commercial Contracting, and Finance

Qualification

Payor contractingRegulatory complianceCommercial contractsJoint Commission accreditationMedicare/Medicaid enrollmentState licensingWordExcelPolicy managementRegulatory audits

Required

An associate degree with a minimum of 7 years of relevant experience is required

A bachelor's degree with 10 or more years of experience is strongly preferred

Preferred

Relevant experience in payor contracting and regulatory compliance at a healthcare provider, payor, or network

Minimum intermediate Word and Excel experience a must

Commercial payor (e.g. medical insurance companies) contracting and relations, preferably within the DME/IDTF provider space

Regulatory compliance and policy management in one (or multiple) of the following fields: DME, IDTF, hospital administration, Medicare, Medicaid, commercial payors

Experience leading regulatory audits, either as auditor or auditee, preferably for Joint Commission accreditation

Experience working with state licensing bodies in the supply of medical products and/or services, preferably within the DME/IDTF provider space