Job Summary:

The Manager, Regulatory Intelligence is responsible for establishing and leading the organization's Regulatory Intelligence function, serving as the central point for regulatory monitoring, requirement management, regulatory strategy support, and regulatory resource development across all programs, clients, and markets.

This role is responsible for designing and maintaining the infrastructure that enables proactive identification, interpretation, organization, communication, and operationalization of regulatory and sub-regulatory requirements. The Manager partners closely with Operations, Account Management, Government Relations, Compliance, Program Integrity, Privacy, Quality, and Client Services teams to ensure regulatory requirements are translated into actionable business guidance and practical operational solutions.

The Manager serves as a trusted regulatory advisor to internal stakeholders and external partners, helping position the organization as a regulatory thought leader while supporting regulatory readiness, audit preparedness, and program growth initiatives.

Regulatory Intelligence Program Development

• Design, implement, and continuously enhance the organization's Regulatory Intelligence function
• Develop and maintain a centralized repository of regulatory requirements, sub-regulatory guidance, policy issuances, program guidance, state directives, and contractual requirements
• Establish methodologies for organizing regulatory content, including determination of team specialization models (e.g., by program, state, regulatory topic, operational function, or client)
• Design and maintain regulatory requirement matrices and crosswalks linking requirements to operational processes, controls, and business owners
• Develop standardized processes for regulatory monitoring, intake, assessment, communication, and implementation support

Stakeholder Engagement and Regulatory Resource Development

• Meet with business units across the organization to assess regulatory support needs and identify opportunities for enhanced regulatory guidance and operational support
• Design and oversee development of regulatory resources, toolkits, implementation guides, operational summaries, FAQs, training materials, and reference documents
• Partner with operational teams to ensure regulatory requirements are translated into practical and scalable business processes
• Establish processes to proactively identify and address emerging regulatory risks and implementation challenges

Regulatory Strategy and Thought Leadership

• Develop standardized regulatory language, content, and boilerplate materials to support proposals, RFP responses, client discussions, and business development activities
• Serve as a regulatory subject matter expert for new program implementations, market expansions, and strategic initiatives
• Support organizational positioning as a trusted regulatory partner and industry thought leader
• Maintain awareness of regulatory trends, emerging program models, and evolving state requirements

Regulatory Relationship Management

• Establish and maintain productive relationships with state agencies, regulatory bodies, oversight entities, and industry stakeholders
• Define and maintain organizational processes for regulatory inquiry management and escalation pathways with state agencies
• Serve as an escalation resource for complex regulatory questions and interpretations
• Collaborate with Government Relations and Account Management teams to ensure coordinated regulatory communications and stakeholder engagement

Governance and Operational Integration

• Define roles, responsibilities, and decision-making authority across Regulatory Intelligence, Account Management, Government Relations, Compliance, and Operations functions
• Establish stakeholder meeting coverage strategies to ensure appropriate regulatory representation across all client and state engagements
• Develop processes for regulatory issue intake, tracking, resolution, and escalation
• Support organizational readiness for regulatory audits, reviews, and assessments

Quality Assurance and Reporting

• Design and oversee quality control processes for regulatory audit responses, state submissions, corrective action responses, and client deliverables
• Develop dashboards, metrics, and reporting tools to measure regulatory compliance, responsiveness, implementation effectiveness, and organizational readiness
• Establish KPIs related to regulatory monitoring, issue resolution, stakeholder support, and implementation activities
• Provide regular reporting and insights to leadership regarding regulatory trends, risks, and opportunities

Required Skills:

• Strong understanding of consumer-directed services, Medicaid, and state-funded long-term services and supports programs
• Demonstrated ability to interpret complex regulatory and sub-regulatory guidance and translate requirements into operationally actionable solutions
• Experience building relationships with state agencies, regulators, and external stakeholders
• Strong organizational and project management skills
• Ability to design scalable processes, tools, and governance structures
• Excellent written, verbal, facilitation, and presentation skills
• Strong stakeholder management and cross-functional collaboration abilities
• Ability to balance strategic thinking with operational execution
• Strong analytical and problem-solving skills

Qualifications:

Education:

• Bachelor's degree required.

Experience:

• Demonstrated experience building, implementing, or supporting multiple consumer-directed services programs across state markets required
• Experience developing and maintaining relationships with state regulatory agencies and oversight entities required
• Experience interpreting and operationalizing Medicaid, LTSS, and consumer-directed program requirements required
• Demonstrated success leading cross-functional initiatives and driving organizational change required
• Strong familiarity with state-specific program requirements, operational implementation considerations, and stakeholder management practices required
• 2+ one years of experience in regulatory compliance, regulatory affairs, program integrity, account management, I&A, or related teams within a Financial Management Services (FMS) organization, with some people management experience

Substantial Experience in Lieu of Degree

Compensation: $92,000- $112,500

This role is eligible for a base salary within the posted range. Actual compensation will be determined based on a variety of factors, including skills, experience, and geographic location. Compensation may vary for positions based in high cost-of-labor markets.

Working Conditions:

• Remote Working Environment

Supervisory Responsibility (If applicable):

• Provides direct leadership, oversight, coaching, and performance management for Regulatory Intelligence personnel, including Regulatory Leads and other regulatory support staff responsible for regulatory monitoring, requirement management, stakeholder engagement, and regulatory resource development.
• Oversees the Credentialing Manager and Regulatory Leads to ensure fulfillment of credentialing requirements across all programs and clients, effective regulatory monitoring and interpretation activities, consistent stakeholder support, and timely escalation of regulatory issues, risks, and implementation challenges.

The above is intended to describe the general contents and requirements of work being performed by people assigned to this classification. It is not intended to be construed as an exhaustive statement of all duties, responsibilities, or skills of personnel so classified.