We're excited about the potential people bring to our organization. You can grow your career here while enjoying first-class perks, benefits and commitment to diversity and inclusion.

The Manager-Compliance, Contracting & Regulatory shall be responsible for the overall execution and monitoring of client contracts, member and plan documents and prospect contract due diligence, as well as the monitoring of laws and regulations relevant to TPA business and client operations. The Manager-Compliance, Contracting & Regulatory will report to the VP-Administration and, under their direction, will be the liaison between Nova business units, the Independent Health Legal Department and any outside legal counsel or vendors. The individual will capture, define, and understand the business needs of Nova and will work to ensure those needs and interests are appropriately represented.

The position will be responsible for ensuring Nova's compliance with the requirements for all applicable federal and state laws and regulations impacting Nova's business as a third-party administrator and Nova's group health plan clients. The position will also work closely with the Client Account Management team to update clients regarding these, as appropriate. Additionally, the Manager-Compliance, Contracting & Regulatory will oversee associate(s) supporting the compliance, contracting & regulatory function to ensure Nova's compliance with laws and regulations governing state licensing, insurance, and health care services.

Any needed legal support to Nova shall be under the direction and oversight of an Independent Health Senior Deputy Counsel and/or Legal Department team member.

• Bachelor's degree required. An additional four (4) years of relevant experience will be considered in lieu of a degree.
• Five (5) years of corporate legal, audit, contract management, employee benefits or compliance experience required; healthcare experience preferred.
• Two (2) years of progressive leadership/management responsibility required.
• Experience with self-funded group health plans preferred.
• Advanced computer and Windows skills required. Experience with Microsoft Office applications and ability to learn new software applications.
• Excellent research skills and exercise independent judgement to determine which changes in regulatory landscape should be presented in collateral and trainings and/or referred to Independent Health's Legal or Compliance Departments. Strong decision-making skills required.
• Excellent analytical skills, ability to analyze components of legislation and implement and draft necessary policies and procedures based upon regulatory requirements.
• Excellent composition and drafting skills, with emphasis on various compliance/regulatory documents and correspondence.
• Excellent communication skills, both verbal and written, and excellent interpersonal skills.
• Ability to effectively build and maintain relationships with both internal and external stakeholders.
• Possess initiative, creativity, project management and organizational abilities.
• Proven examples of displaying the Nova values: Passion, Caring, Trustworthy, Collaborative, Respectful and Accountable.

Monitoring of Laws & Regulations:

• Work with Nova business units to research, define, capture, and understand the business needs to support the review, negotiation, and execution of all registrations, agreements, and contracts for Nova. This includes defining business prospect requirements and relevant regulations during the sales governance process.
• Research statutes and federal regulations concerning TPA, insurance adjuster, utilization review, and other applicable requirements related to the TPA business; monitor and track for any changes or updates.
• Research and maintain an understanding of compliance obligations of clients, including, but not limited to ERISA, HIPAA, COBRA, and Health Reform, and provide recommendations to client account management to communicate, as appropriate.

Client Contracting & Member Issues:

• Facilitate and oversee the client contracting process, for all documents such as: Master Service Agreements (MSAs) Administrative Service Agreements (ASAs), Amendments, NDAs, and BAAs, and vendor agreements.
• Create draft documents, as well as review, edit, negotiate, and facilitate the execution of all client agreements and contracts.
• Facilitate and oversee member correspondence relating to member liens, member lawsuits, member HIPAA release inquiries, member adverse benefit determinations and appeals and other member documents as required.
• Serve as point of contact and front-line support at Nova to respond/triage member legal, compliance or privacy and security questions, and coordinate with Independent Health Legal/Compliance, outside legal, and other outside vendors, as necessary.
• Develop, implement, and maintain tracking and monitoring processes to ensure compliance with client contract terms and conditions.
• Facilitate the timely review and renewal of all client contracts, as necessary.
• Facilitate coordination with Independent Health Legal and Vendor Contracting departments, outside legal counsel and vendors supporting clients, members, and plans.

Licensing & Compliance Management:

• Oversee facilitation, tracking and monitoring of Nova's business registrations and licenses in various states in which Nova conducts or wishes to conduct business.
• Oversee facilitation, tracking and monitoring processes to ensure licensing compliance of Nova associates, including coordination with other departments for professional, sales and clinical licensure.
• Oversee coordination with Independent Health Compliance department, including but not limited to review and approval of distribution of companywide compliance & regulatory training materials.
• Oversee coordination with Independent Health corporate Privacy, Security & Information Risk department.
• Coordinate with Independent Health Legal and Compliance departments as appropriate.
• Oversee coordination with Nova and Independent Health corporate finance and facilities departments.

Immigration or work visa sponsorship will not be provided for this position

Hiring Compensation Range: $75,000 - $90,000 annually

Compensation may vary based on factors including but not limited to skills, education, location and experience.

In addition to base compensation, associates may be eligible for a scorecard incentive, full range of benefits and generous paid time off. The base salary range is subject to change and may be modified in the future.

As an Equal Opportunity / Affirmative Action Employer, Independent Health and its affiliates will not discriminate in its employment practices due to an applicant's race, color, creed, religion, sex (including pregnancy, childbirth or related medical conditions), sexual orientation, gender identity or expression, transgender status, age, national origin, marital status, citizenship and immigration status, physical and mental disability, criminal record, genetic information, predisposition or carrier status, status with respect to receiving public assistance, domestic violence victim status, a disabled, special, recently separated, active duty wartime, campaign badge, Armed Forces service medal veteran, or any other characteristics protected under applicable law. Click here for additional EEO/AAP or Reasonable Accommodation information.

Current Associates must apply internally via the Job Hub app.