Regulatory Implementation Manager
Who are we?
Versant Health is one of the nation’s leading administrators of managed vision care, serving millions of our clients’ members nationwide. We are driven by our mission to help members enjoy the wonders of sight through healthy eyes and vision.
As a Versant Health associate, you can enjoy a comprehensive Total Rewards package, which includes health and dental insurance, tuition reimbursement, 401(k) with company match, pet insurance, no-cost-to-you vision insurance for you and your qualified dependents. We are also invested in your success. There are many opportunities for advancement and development throughout all stages of your career with us.
See how you can make a difference with the support of strong leadership and a team environment.
See Everything, Be Anything™.
What are we looking for?
The Regulatory Implementation Manager reports to the Senior Director - Compliance Implementation, Monitoring and Remediation and leads the planning and execution of a portfolio of projects driven by regulatory requirements. The Implementation Manager will partner with key stakeholders across the organization and the regulatory compliance department to determine priority and ownership of the implementation of compliance regulations and regulatory changes in addition to defining timelines, resource needs, and other key project inputs. This role acts as a thought leader and subject matter expert to the operations and IT teams (amongst others) by driving alignment and understanding of critical regulations and the end-to-end processes required to support compliance.
Where you will have an impact
- Manage a portfolio of 20+ implementation projects ranging in size from very small to medium
- Review regulatory requirements deemed applicable to Versant Health, organize the information to enable efficient discussions, and partner with operational and IT areas to ensure implemenation of required changes is completed
- Guide operational areas such as claims, call center, utilization management, and complaints and appeals through the process of determining the business impact of new regulations
- Facilitate cross-functional collaboration between operations, IT and regulatory compliance to determine scope and level of effort needed to implement new regulatory requirements
- Create implementation plans to confirm end-to-end processes and systemic support are accounted for and addressed during each implementation
- Track implementation plan timelines and drive operational and IT areas to meet agreed upon deadlines
- Document key decisions reached by operations, IT, regulatory compliance and legal teams during the implementation
- Organize all implementation related information such that each new regulatory requirement is linked to an implementation activity and supporting documentation
- Partner with operational areas to ensure supporting processes, policies, procedures and controls established by the operational area accurately fulfill regulatory requirements
- Collaborate with the regulatory compliance department to complete a quality review of implementation deliverables to confirm compliance
- Construct and present reporting that summarizes the portfolio of iimplementation projects, including regulatory themes and key risks
- Prepare and present executive and client-ready presentation materials related to regulatory implementation
- Conduct or participate in special projects, programs and requests as needed.
- Other duties as assigned
What’s necessary to do the job?
- Bachelor’s in business administration, health care administration, or related field or equivalent combination of education and experience
- Minimum of five (5) years of related experience in implementation, project management, regulatory compliance and/or healthcare operations required
- Strong Excel skills required
- Knowledge and experience in the health insurance or vision care industry required
- Knowledge and experience with Centers for Medicare & Medicaid Services (CMS) and State Medicaid agency requirements
HIPAA & Security Requirements
All Associates must comply with the Health Insurance Portability Accountability Act of 1996 (HIPAA) as it pertains to disclosures of protected health information (PHI) as described in the Notice of Privacy Practices and HIPAA Privacy Policies and Procedures. As a component of job roles and responsibilities, Associates may have access to covered information, cardholder data or other confidential customer information which must be protected at all times. As a result, Associates must explicitly adhere to all data security guidelines established within the Company’s Privacy & Security Training Program.
Versant Health will never request money from candidates who seek employment with us and will never ask for any payment as part of the recruitment process.
Versant Health is a proud Equal Employment Opportunity and Affirmative Action employer dedicated to attracting, retaining, and developing a diverse and inclusive workforce. All qualified applicants will receive consideration for employment at Versant Health without regards to race, color, religion, sex (including pregnancy, childbirth, or related medical conditions), sexual orientation, gender identity or expression, age, disability, national origin, marital or domestic/civil partnership status, genetic information, citizenship status, uniformed service member or veteran status, or any other characteristic protected by law.
