Regulatory Consultant V
In this role, you will be responsible for leading California state regulatory initiatives across all functions statewide, as well as managing relationships and maintaining communications with stakeholders at all levels, both internally and externally. You will research, plan, implement, and monitor a broad portfolio of regulatory systems and initiatives to enable organizational compliance with all applicable federal, state, and local regulations/laws and advise the organization on all regulatory matters related to the Department of Managed Health Care (DMHC) and other state regulators. On an on-going basis, you will research and interpret regulations and laws to establish standards, and may develop and/or deliver training and communications/change management relative to new standards. Other responsibilities include assessing organizational systems (both physical and process or data related) to determine gaps in compliance and determine opportunities for remediation; advising the organization on all compliance matters; and investigating violations of compliance policy, laws, and regulations or conduct on-going monitoring and reporting to ensure remediation. You may be responsible for project management relative to new compliance initiatives, products, or annual processes. In addition, you will be responsible for all regulatory filings related to Health Plan’s Knox-Keene license (ex. contracts, benefits, delivery systems, new products) and interpreting benefits to ensure statewide consistency in providing benefits to members and compliance with benefits provisions in contracts.
- At least nine years of health care experience or other applicable experience-health care operations, audit, finance, project management, regulatory or public policy development, investigations, information security, or insurance/health plan governance experience
- Years spent in law school that resulted in a law degree may count as applicable job experience; JD will be counted in lieu of three years of experience
- A bachelor’s degree or four years of experience in a directly related field with a high school diploma or GED
- Advanced knowledge of health care operations, regulatory policies, practices and systems, and regional operational differences
- The ability to contribute to the development of regulatory concepts
- Broad knowledge of health care industry practices and standards
- The ability to draft and revise documents including analyses and reports
- Project management and/or consulting skills
- Contract writing experience preferred
For immediate consideration, please visit http://kp.org/careers for complete qualifications and job submission details, referencing job number 684851.
External hires must pass a background check/drug screen. Qualified applicants with arrest and/or conviction records will be considered for employment in a manner consistent with Federal, state and local laws, including but not limited to the San Francisco Fair Chance Ordinance. All qualified applicants will receive consideration for employment without regard to race, color, religion, sex, national origin, sexual orientation, gender identity, protected veteran, or disability status.
This position supports Kaiser Permanente’s code of conduct and compliance by adhering to all laws and regulations, accreditation and licensure requirements, and internal policies and procedures.