Program Manager Health Plans Regulatory Affairs - HP Regulatory -

CHRISTUS Health System; Irving (TX); On-site; USD 110,000 - 140,000; Full time

Job summary

CHRISTUS Health is seeking a Program Manager for Health Plans Regulatory Affairs in Irving, TX. The role supports implementing and maintaining the Compliance Program and coordinates internal audits, training, and regulatory education across Health Exchange and Medicare lines of business.

The candidate will monitor risk, respond to regulatory inquiries, and partner with leadership to drive efficient processes. Requires a Bachelor’s degree and 4–6 years of related experience.

Qualifications

• Bachelor's Degree in Related Field of Study or equivalent years of work experience required.

Responsibilities

• Meets expectations of the OneCHRISTUS Competencies: Leader of Self, Leader of Others, or Leader of Leaders.
• Review and research laws and regulations to ensure compliant responses for Medicare Advantage and Health Exchange lines of business.
• Monitor Health Plan progress in resolution of issues from risk assessments and audit findings.
• Analyze and report risk-related trends to the Compliance Committee.
• Perform internal monitoring and audits based on risk level.
• Support implementation of consistent processes to enhance day-to-day compliance.
• Provide specialized education and development of training materials.
• Follow up on action items from audit requests and compliance issues.
• Collaborate with Regulatory Affairs to streamline cross-line processes.
• Cross-train the regulatory affairs team on compliance tasks.
• Maintain excellent interpersonal communication with Senior Leadership and associates.
• Facilitate resolution of issues to support a high-performing team.
• Manage project/monitoring work plans to achieve goals and objectives.
• Coordinate assigned projects and prepare updates for leadership and regulatory bodies.
• Serve as Project Manager on external audits conducted by regulatory bodies.
• Provide regulatory guidance for Health Exchange and Medicare Lines of Business.
• Perform other duties as assigned.

Education

Bachelor's Degree in Related Field of Study

Job description

Summary:

The Program Manager Health Plans Regulatory Affairs role is to assist in the implementation and maintenance of the CHRISTUS Health Compliance Program. This job assists the Regulatory Affairs team in the execution of established work priorities and plans, management, and monitoring of operational compliance related tasks. These tasks are to include internal auditing and monitoring activities, external audit coordination, and regulatory training and education.

Responsibilities:

• Meets expectations of the applicable OneCHRISTUS Competencies: Leader of Self, Leader of Others, or Leader of Leaders.
• Review and research laws and regulations both on a reactive and proactive basis to ensure an effective and accurate response to legal and regulatory compliance for Medicare Advantage and Health Exchange lines of business.
• Monitors Health Plan progress in resolution of issues identified through the Risk Assessment and Monitoring Work Plan and internal and external audit findings.
• Analyze and periodically report on risk-related trends to the Compliance Committee to ensure organizational awareness of potential noncompliance.
• Perform ongoing internal monitoring/audits based on risk level.
• Support implementation of consistent processes to enhance compliance within day-to-day health plan operations.
• Provide specialized education and development of materials as requested.
• Follow up with Action items necessary related to various audit requests and compliance related issues.
• Work with the regulatory affairs team to develop streamlined approaches between lines of business.
• Cross-train the regulatory affairs team on compliance related tasks to ensure operational compliance goals are met.
• Excellent interpersonal skills with regular interaction and communication with the Senior Leadership team and other associates within the organization.
• Ability to facilitate the resolution of issues and concerns that create barriers to a high-performing team and work environment.
• Ability to manage project/monitoring work plans for achieving project goals and objectives.
• Coordinates assigned projects, including monitoring projects to present to leadership and regulatory bodies.
• Serves as Project Manager on external compliance audits conducted by regulatory bodies.
• Serves as a resource in regulatory guidance for Health Exchange and Medicare Lines of Business.
• Performs other duties as assigned.

Job Requirements:

Education/Skills

• Bachelor's Degree in Related Field of Study and or equivalent years of work experience required

Experience

• 4 - 6 years of related experience preferred

Licenses, Registrations, or Certifications

• None required

In accordance with the CHRISTUS Health License, Certification and Registration Verification Policy, all Associates are required to obtain the required certifications for their respective positions within the designated time frame.

Work Schedule:

8AM - 5PM Monday-Friday

Work Type:

Full Time