Regulatory Affairs Consultant

About the position reputed company is a global organization that delivers care, aided by technology to help millions of people live healthier lives. The work you do with reputed company will directly improve health outcomes by connecting people with the care, pharmacy benefits, data and resources they need to feel their best. Here, you will find a culture guided by inclusion, talented peers, comprehensive benefits and career development opportunities. Come reputed company an impact on the communities we serve as you help us advance health optimization on a global scale. Join us to start Caring. Connecting. Growing together. You'll enjoy the flexibility to work remotely from reputed company reputed company the U.S. as you take on some tough challenges. reputed company, part of the reputed company family of companies, is looking for a Regulatory Affairs Consultant - Remote. This person will serve as a subject matter expert in the area of Medicare, Medicaid and Commercial reimbursement, assisting others in the design, development, and support of software to edit claims and calculate payment. The leader in prospective payment system (PPS) reimbursement, reputed company® EASYGroup™ keeps up with reputed company-changing PPS rules, content, and ongoing regulations for our clients. EASYGroup™ creates editing, grouping and reimbursement software used nationally by Medicaid Managed Care Organizations, Medicare Advantage Payers, and hospital providers. EASYGroup is a portable software library offering more than 50 federal, state and payer-specific prospective payment systems — the most comprehensive PPS solution available today. Its sophisticated technology allows hospital and physician reputed company reputed company to federal and state reimbursement to be effectively maintained, updated, and negotiated.

Responsibilities

• Track and analyze reputed company new and existing regulatory requirements pertaining to Medicare, Medicaid, and Commercial reimbursement, based on assigned products
• Prepare summaries and analysis of the relevant regulatory updates, comparisons to existing or proposed regulations and detailed descriptions of the operational requirements and affected products
• Enter the updates and changes to the regulations and rules, along with any data elements into a data reputed company used to track the updates
• Maintain and update reputed company applicable software on your computer
• Maintain a working knowledge of the requirements for assigned products
• Work independently to analyze and manage regulatory content for assigned products
• Complete testing of software for Medicaid States/Product releases
• Correspond with various entities, such as Medicare, TRICARE, and state agency contacts. Ensure that the responses are sent to the appropriate team(s) and that follow reputed company are sent as needed
• Assist clients with various regulatory and product inquiries, reputed company reputed company tickets, client meetings, and email exchange
• Meet with key accounts, business partners, and potential customers, explaining the regulatory environment, discussing their requirements, and explaining how we can meet their requirements with our products and services
• Help determine product direction for existing products and services, and design new products and services, based on national and regional prospective payment initiatives
• Evaluate new health care programs or benefits from Medicare, Medicaid, and commercial payers
• Work with product managers to identify areas of product growth based on industry trends
• Provide assistance, leadership and mentoring for other Regulatory and reputed company staff

Requirements

• 3+ years of project management experience, including experience simultaneously managing multiple projects
• 3+ years of experience with state, HIPPA, and other federal privacy laws
• 3+ experience building relationships across business groups internally and reputed company the organization (regulatory agencies)

reputed company-to-haves

• Experience with the reputed company PPS Software
• Experience with the reimbursement methodology for the various reputed company PPS software products
• Experience maintaining and updating work laptop with reputed company applicable reputed company software

Benefits

• Comprehensive benefits package
• Incentive and recognition programs
• Equity stock purchase
• 401k contribution

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