Job Description

Job Description

An Innova Solutions Client is immediately hiring for a Regulatory Guidance Specialist – Government Programs

Position type: Full-time/Direct Hire

Location: New York, NY (REMOTE, must be within commuting distance to NYC)

Regulatory Guidance Specialist – Government Programs

The Regulatory Guidance Specialist is responsible for ensuring regulatory compliance by disseminating guidance to affected business units. The position will develop and maintain relationships with regulatory agencies and stay up to date on any changes or updates to regulations. The position is accountable for supporting the Director of State Regulatory Guidance and will provide guidance to staff as well as conduct regulatory research and analysis to identify and interpret regulatory requirements and trends.

Job Description

• Ensure timely dissemination of accurate guidance for applicable laws and regulations related to all regulated Lines of Business (LOBs) that the Plan offers.
• Develop and coordinate with the Project Management Team (PMO) and the Product Team on workplans to implement new regulatory changes.
• Provide guidance and conduct regulatory research and analysis to help identify and interpret requirements and trends.
• Evaluate the impact of regulatory changes on the organization and advise plan leadership on necessary actions.
• Develop and maintain relationships with regulatory agencies and stay up-to-date on any changes or updates to regulations.
• Participate in stakeholder calls and create summaries of calls for dissemination to senior staff.
• Work with the Compliance Operations team to manage the preparation and submission of regulatory filings, reports, and documentation.
• Identify and assess potential regulatory risks and develop strategies to mitigate those risks.
• Collaborate with cross-functional teams to ensure compliance across all areas of the organization.
• Participate in high-level implementations of carve-in/carve-out services; program services such as changing vendors or adding new vendors.
• Participate in various external audits/surveys such as the Article-44 Operational Survey to ensure compliance with state regulations. Upload all requested information into the Health Commerce System (HCS), the state’s database, as necessary.
• Other duties as assigned by the Director, Senior Director, or Chief Compliance & Regulatory Officer.

Minimum Qualifications

• Bachelor's degree required; and
• 5+ years of Regulatory Affairs work experience; or
• A satisfactory equivalent combination of education, training, and experience in other Managed Care operational departments.
• Master’s degree or Juris Doctorate preferred.
• Experience with NY State managed care products strongly preferred.
• Strong knowledge of healthcare laws and regulations, including HIPPA, Medicare and Medicaid.
• Proficient MS Word, Excel, SharePoint and PowerPoint required.

PAY RANGE AND BENEFITS:

Pay Range*: $90k per year

*Pay range offered to a successful candidate will be based on several factors, including the candidate's education, work experience, work location, specific job duties, certifications, etc.

Benefits provided by client as this is a Direct Hire position

ABOUT INNOVA SOLUTIONS: Founded in 1998 and headquartered in Atlanta, Georgia, Innova Solutions employs approximately 50,000 professionals worldwide and reports an annual revenue approaching $3 Billion. Through our global delivery centers across North America, Asia, and Europe, we deliver strategic technology and business transformation solutions to our clients, enabling them to operate as leaders within their fields.

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Recent Recognitions:

• Named One of America’s Best Employers for New Grads by Forbes (2024
• Named One of the Best Companies to Work For by U.S. News & World Report (Private Companies List, 2024-2025)
• One of the Largest IT Staffing Firms in the US – Ranked #3 by Staffing Industry Analysts (SIA, 2024)
• One of the Largest Staffing Firms in the US – Ranked #13 by Staffing Industry Analysts (SIA, 2024; includes Innova Solutions, Volt, & HireGenics)
• Named One of the Top Ten Private Companies in Atlanta by the Atlanta Business Chronicle (2023)
• One of the Largest Certified Minority Business Enterprises (MBEs) in the United States (NMSDC, 2024)
• AWS Advanced Tier Services Partner with 100+ certifications

Innova Solutions is an Equal Opportunity Employer and prohibits any kind of unlawful discrimination and harassment. Innova Solutions is committed to the principle of equal employment opportunity for all employees and to providing employees with a work environment free of discrimination and harassment on the basis of race, color, religion or belief, national origin, citizenship, social or ethnic origin, sex, age, physical or mental disability, veteran status, marital status, domestic partner status, sexual orientation, or any other status protected by the statutes, rules, and regulations in the locations where it operates. If you are an individual with a disability and need a reasonable accommodation to assist with your job search or application for employment, please contact us at hr@innovasolutions.com or (770) 493-5588. Please indicate the specifics of the assistance needed. Innova Solutions encourages all interested and qualified candidates to apply for employment opportunities. Innova Solutions (HireGenics/Volt) does not discriminate against applicants based on citizenship status, immigration status, or national origin, in accordance with 8 U.S.C. § 1324b.

The company will consider for employment qualified applicants with arrest and conviction records in a manner that complies with the San Francisco Fair Chance Ordinance, the Los Angeles Fair Chance Initiative for Hiring Ordinance, and other applicable laws.

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