Manager, Regulatory Affairs
1 Full Time (1.0 FTE) position (Mon. - Fri., 8:00am-4:30pm)
Under the general supervision of the Vice President of Health Plan Operations, the Regulatory Affairs Manager position is responsible for overseeing the development and implementation of Care Wisconsin’s compliance program and other activities necessary to ensure compliance with all applicable laws, regulations and contractual requirements. The Regulatory Affairs Manager serves as the Compliance Officer for Care Wisconsin, Inc.  This senior level staff position has the authority to review all documents and other information relevant to compliance and regulatory affairs activities including, but not limited to, patient records, billing records, contracts, and records relating to marketing as well as Care Wisconsin’s arrangements with other parties, including hospitals, physician practices, independent contractors, vendors and agents.  The Regulatory Affairs Manager is committed to the mission of Care Wisconsin; and as a member of the management team, is expected to maintain complete confidentiality in matters related to participant care and staff interactions.

Requirements:

• Bachelor’s Degree from an accredited college or university in finance, health care administration, business administration, public/government administration, pre-law or related area.
• Minimum of five years of administrative experience in health insurance industry, HMO, or other managed care organization or a similar setting.
• Knowledge of health insurance industry and terminology, legal research and terminology, medical terminology, and basic accounting and business.

Preferred:

• Experience with compliance and regulatory duties.
• Master’s Degree/Law Degree.
• Knowledge of Microsoft Office Suite