Job Summary
Acts as the primary organization-wide contact and subject matter expert for regulatory, policies and/or contracting processes and procedures that are complex or of a high level of importance to the organization; takes the lead role in consultation and education for business units. For contracting, identifies and develops standard contract terms, client self-help tools, and drafts, negotiates and manages the review process and execution of complex contracts within their area of expertise. For regulatory processes, interacts with applicable state or federal agencies or regulating or accrediting bodies; identifies, prepares and submits complex documents and forms; takes a lead role in ensuring compliance with legal and regulatory requirements as required by the regulating bodies. For policies, acts as the subject matter expert for the policies process and in that capacity leads education, training and communication on policy making process including proactive review and auditing. Identifies and initiates complex legal projects that impact client and legal department processes that are of a high level of importance to the organization. Possesses and applies specialized expertise in relevant subject matter to support complex client and legal department needs. Takes the lead on analyzing, interpreting, and responding to client requests, recommends direction, coordinates and implements process change, and identifies client education and process improvement needs and provides education to promote efficiencies and standard work in area of responsibility. Regularly provides oversight, guidance and training to team members. Carries out job duties in a confidential and professional manner.
Essential Functions
- Develops and reviews contracts and/or complex legal and regulatory documents that are of a high level of importance for the organization.
- Provides oversight and supervision of other individuals and functions as requested.
- Regularly leads complex projects from start to finish; including creating an effective project plan, presenting recommendations, meeting deadlines, proactively investigating and resolving problems, and collaboratively coordinating and leading others around process change.
- Manages, documents and regularly finds improvements and efficiencies for complex processes, procedures and outcomes to seek continuous improvement related to projects.
- Conducts research applicable to project assignment, gathers and complies data, interpret and analyze data, including creating written recommendations and reports with research findings with little direction required from manager.
- Regularly develops complex educational materials and communications, takes the lead on proposing, creating, and presenting educational programs and/or conducting training on subject matters with effective presentation skills for small or large groups.
- Designs, develops and maintains complex system programs and applications . Works on complex matters with a high level of importance to the organization independently or taking the lead to collaborate with a group of people and act as a change agent to advance initiatives.
- Takes the lead to effectively communicate and collaborate with others on complex matters, and act as a liaison to stakeholders/business partners in areas of a high level of importance to the organization. Cultivates relationships across the organization. Maintains a current level of knowledge and expertise in complex areas specific to assigned projects and documents knowledge, materials and advice to be used by others in the future.
Qualifications
Required
- Bachelor's Degree or equivalent in legal, compliance, managed care, health plan administration, process improvement or project management
- 5 years of relevant experience Substantive knowledge of the legal and regulatory environment applicable to the business unit(s) or subject matter area assigned
Preferred
- 7 years of relevant experience Substantive knowledge of the legal and regulatory environment applicable to the business unit(s) or subject matter area assigned
- 5 years of relevant experience Previous leadership experience for projects and/or staff
- Project management
Primary LocationSITE - 1700 Magnavox Way Suite 201 - Fort Wayne
Department NamePhysicians Health Plan of Northern Indiana Admin - PH Managed Benefits
Employment TypeFull time
ShiftDay (United States of America)
Weekly Scheduled Hours40
Hours of Work8 a.m. to 5 p.m.
Days WorkedMonday to Friday
Weekend FrequencyN/A
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