Providence Health & Services Manager - Regulatory Affairs in Beaverton, Oregon


Providence is calling a Regulatory Affairs Manager to Providence Health Plan in Beaverton, OR.

This is an exciting time in healthcare! Come join one of the largest insurers in

Oregon as our Regulatory Affairs Manager and interact with top level executives

to balance compliance with business needs while adhering to federal and state

legal obligations in a constantly changing environment.

We are looking for an experienced manager with a passion and

background in compliance to help us build and develop our growing commercial compliance

team at the Providence Health Plans. If

you have management experience and a background in compliance, preferably but

not limited to healthcare, we want you!

Apply today for confidential consideration. Let’s start theconversation!

In this position, you will:

  • Be responsible for managing various aspects of regulatory consulting for commercial health plan business.

  • Be responsible for managing interpretation and dissemination of state and federal regulatory requirements.

  • Oversee Qualified Health Plan and Affordable Care Act § 1557 non-discrimination compliance functions.

  • Develop, manage and communicate internal subject matter expertise regarding the foregoing functions and acts as a consultant to leadership and staff at Providence Health Plan (PHP).

  • Act as key point of contact with CMS regarding PHP federal exchange participation.

  • Be responsible for work that impacts PHP’s legal and regulatory obligations as well as financial obligations to commercial Providence Health Plan customers.

Principal Duties and Functions:

  • Manages theinterpretation and dissemination of state and federal guidance regardingcommercial health plans to PHP leadership and staff, while consideringcontinuously changing regulatory landscape.

  • Working with the Sr.Director – Regulatory Affairs and RCGA staff, leads PHP’s efforts toassure compliance with state and federal statutes, regulations, andcontractual requirements with respect to PHP commercial lines of business.

  • Responsible forfostering and maintaining the compliance relationship between PHPcompliance staff and CMS Region 10 account management personnel.

  • Oversees thedevelopment and continual improvement of PHP compliance structuresregarding commercial products, including development of documentedpolicies and adherence to requirements related to downstream delegatedentities.

  • Responsible formanaging 5 direct reports, including hiring, coaching, development, anddiscipline.

  • Develops and deliverstraining and educates internal and external audiences regarding federaland state legal and regulatory requirements.

  • Consults with managers andstaff to establish administrative procedures that meet all state andfederal compliance requirements and to resolve related problems asapplicable to PHP’s commercial lines of business.

  • Develops and deliverseducational presentations regarding commercial policy and regulatoryissues to internal and external audiences.

  • Performs other projectsand duties as assigned.


Required qualifications for this position include:

  • Bachelor’s degree in business administration, economics, healthcare administration, or other related field

  • 2 years of demonstrated successful experience working with administrative, policy and/or operational aspects of the health plan industry

  • 1 year of management experience

Preferred qualifications for this position include:

  • Law degree

  • 4 years of demonstrated successful experience working with administrative, policy and/or operational aspects of the health plan industry in a managed care environment

  • 2 years of management experience

  • Management experience in managed care environment specific to a health plan

  • Prior experience with health plan regulatory compliance matters

About Providence in Oregon

As the largest healthcare system and largest private employer in Oregon, Providence offers exceptional work environments and unparalleled career opportunities.

The Providence Experience begins each time our patients or their families have an encounter with a Providence team member and continues throughout their visit or stay. Whether you provide direct or indirect patient care, we want our patients to feel that they are in a welcoming place where they can be comfortable and free from anxiety. Our employees create the Providence Experience through simple, caring behaviors such as acknowledging and welcoming each visitor, introducing ourselves and Providence, addressing people by name, providing the duration of estimated wait times and updating frequently if timelines change, explaining situations in a way that puts patients at ease, carefully listening to their concerns, and always thanking people for trusting Providence for their healthcare needs. At Providence, our quality vision is simple,

"Providence will provide the best care and service to every person, every time."

Providence is consistently ranked among the top 100 companies to work for in Oregon. It is also home to two of our award-winning Magnet medical centers. Providence hospitals and clinics are located in numerous areas, ranging from the Columbia Gorge to the wine country to sunny southern Oregon to charming coastal communities to the urban setting of Portland. If you want a vibrant lifestyle while working with a team highly committed to the art of healing, choose from our many options in Oregon.

We offer a full comprehensive range of benefits - see our website for details

Our Mission

As people of Providence, we reveal God's love for all, especially the poor and vulnerable, through our compassionate service.

About Us

Providence Health & Services is the third largest not-for-profit health system in the United States. Providence employs more than 82,000 caregivers (employees) across a five-state area; AK, WA, MT, OR, and CA. Our facilities include 34 hospitals, 600 physician clinics, senior services, supportive housing and other health and educational services. Providence is proud to be an Equal Opportunity Employer. Providence does not discriminate on the basis of race, color, gender, disability, veteran, military status, religion, age, creed, national origin, sexual identity or expression, sexual orientation, marital status, genetic information, or any other basis prohibited by local, state, or federal law.

Schedule: Full-time

Shift: Day

Job Category: Administrative (Non-Clinical)

Location: Oregon-Beaverton

Req ID: 143562