Regulatory Manager, LTC Products - Hybrid NY

Description and Requirements

The Regulatory Manager, LTC Product will serve as the Managed Long-Term Care (MLTC) products subject matter expert to work with business units across the enterprise to ensure that new products and programs are administered according to approved benefit design, regulatory requirements, and strategic objectives for the line of business. This position will also maintain, ensure, and foster an environment that enhances and promotes compliance, adherence to corporation's ethical standards and conformance to all relevant federal, state and local laws, rules and regulations applicable to the company's State and Federal contracts for Healthfirst's Long-Term Care product offerings.

Hybrid work schedule consists of reporting to our 100 Church Street, NYC office 3 days per week.

Scope of Responsibilities:

In this role, you will:

• Be responsible for supporting the Long-Term Care lines of business strategy and execution.
• Be knowledgeable in Long-Term Care products, including but not limited to the Partial Capitation Managed Long-Term Care plan, the Medicaid Advantage Plus (MAP) and/or Program of Complete Care for the Elderly (PACE) products.
• Work with the appropriate business areas to ensure that strategic, operational, and tactical business plans for new products are achieved in accordance with CMS and the NYSDOH requirements.
• Assist the appropriate business areas, including Regulatory Change Management, to implement special projects, initiatives, and activities to support line of business objectives, product, benefit administration, process improvement, efficiency, and customer experience in accordance with CMS and NYSDOH requirements.
• Develop & maintain relationships across the enterprise to promote consistent strategic priorities.
• Serve as a regulatory liaison to CMS, NYSDOH, or other regulatory agencies as needed.
• Represent the Regulatory Affairs department on related key cross-functional committees and projects to ensure MLTC perspective is being integrated into strategies of other areas.
• Read, interpret, and identify necessary next steps related to complex government regulations.
• Collaborate with the Healthfirst Compliance department, oversees the implementation and effectuation of all plans of correction developed for both internal and external audits.
• Act as a consultant to internal departments regarding regulatory issues while understanding the underlying root cause and applicable regulatory requirements, conducts analysis of risk, and recommends or initiates necessary corrective action.
• Review & approve policies and procedures, and marketing materials as well as submit reporting requirements to CMS/NYSDOH to ensure regulatory requirements are met.
• Be responsible for bringing pertinent items to Healthfirst Regulatory Change Management and seeing projects through to fruition to ensure all associated deadlines are met.
• Work in collaboration with the Regulatory Audit Manager on all external agency audits/site visits.

Minimum Qualifications:

• Bachelor's degree from an accredited institution or equivalent work experience.
• Strong leadership and/or management experience in Managed Long-Term Care programs compliance or regulatory program at a health plan, provider, law firm, state regulatory agency or consulting firm.
• Strong expertise and background dealing with regulatory agencies such as CMS, NYSDOH, etc.
• Strong process and program management skills, analytical, creativity and initiative in problem solving and solution identification.
• Must be capable of establishing effective relationships with all levels of representation throughout the organization.
• Strong facilitation skills and follow-through.

Hiring Range:

• Greater New York City Area (NY, NJ, CT residents): $100,900 - $145,775
• All Other Locations (within approved locations): $86,500 - $128,690

As a candidate for this position, your salary and related elements of compensation will be contingent upon your work experience, education, licenses and certifications, and any other factors Healthfirst deems pertinent to the hiring decision.

In addition to your salary, Healthfirst offers employees a full range of benefits such as, medical, dental and vision coverage, incentive and recognition programs, life insurance, and 401k contributions (all benefits are subject to eligibility requirements). Healthfirst believes in providing a competitive compensation and benefits package wherever its employees work and live.

The hiring range is defined as the lowest and highest salaries that Healthfirst in "good faith" would pay to a new hire, or for a job promotion, or transfer into this role.

WE ARE AN EQUAL OPPORTUNITY EMPLOYER. HF Management Services, LLC complies with all applicable laws and regulations. Applicants and employees are considered for positions and are evaluated without regard to race, color, creed, religion, sex, national origin, sexual orientation, pregnancy, age, disability, genetic information, domestic violence victim status, gender and/or gender identity or expression, military status, veteran status, citizenship or immigration status, height and weight, familial status, marital status, or unemployment status, as well as any other legally protected basis. HF Management Services, LLC shall not discriminate against any disabled employee or applicant in regard to any position for which the employee or applicant is otherwise qualified.

If you have a disability under the Americans with Disability Act or a similar law and want a reasonable accommodation to assist with your job search or application for employment, please contact us by sending an email to careers@Healthfirst.org or calling 212-519-1798 . In your email please include a description of the accommodation you are requesting and a description of the position for which you are applying. Only reasonable accommodation requests related to applying for a position within HF Management Services, LLC will be reviewed at the e-mail address and phone number supplied. Thank you for considering a career with HF Management Services, LLC.

Know Your Rights

Client-provided location(s): New York, NY

Job ID: healthfirst-R020685

Employment Type: OTHER

Posted: 2025-07-23T12:40:05