Regulatory Operations Director, Managed Care Compliance

20 Driscoll Children's Health Plan; Corpus Christi (TX); On-site; USD 150,000 - 210,000; Full time

Job summary

Driscoll Health Plan is seeking a Director of Regulatory Operations to develop and oversee a comprehensive regulatory program. The role involves coordinating with internal stakeholders, managing government filings for HHSC, OIG, and other agencies, and leading a team to ensure compliance with evolving state and federal requirements.

The director will engage regulators, communicate guidance, and represent the plan in regulatory meetings and industry groups to inform operational decisions.

Qualifications

• JD or equivalent legal training strongly preferred; Bachelor’s degree required.
• Experience in managed care, health plan operations, or regulatory oversight is a plus.
• Strong knowledge of state and federal regulations and contractual requirements.

Responsibilities

• Develops, implements and oversees an effective regulatory program for the health plan.
• Coordinate and communicate regulatory requirements to internal stakeholders.
• Oversee regulatory reports, filings and audits with HHSC, OIG, TDI and others.
• Establish and maintain relationships with external regulatory agency representatives.
• Represent the health plan in regulatory oversight meetings and industry groups.
• Mentor regulatory staff and ensure cross-coverage for agility and effectiveness.

Skills

Regulatory compliance

Regulatory reporting

Stakeholder communication

Contract management

Regulatory liaison

Team leadership

Education

JD

Paralegal certificate

Bachelor’s degree

Job description

Driscoll Health Plan is seeking a Director of Regulatory Operations to develop and oversee a comprehensive regulatory program. The role involves coordinating with internal stakeholders, managing government filings for HHSC, OIG, and other agencies, and leading a team to ensure compliance with evolving state and federal requirements.

The director will engage regulators, communicate guidance, and represent the plan in regulatory meetings and industry groups to inform operational decisions.