USA
1 day ago
Regulatory Performance Sales Operations Manager (Remote)
Your career starts now. We’re looking for the next generation of healthcare leaders. At AmeriHealth Caritas, we’re passionate about helping people get care, stay well, and build healthy communities. As one of the nation's leaders in healthcare solutions, we offer our associates the opportunity to impact the lives of millions of people through our national footprint of products, services, and award-winning programs. AmeriHealth Caritas is seeking talented, passionate individuals to join our team. Together, we can build healthier communities. If you want to make a difference, we’d like to hear from you. Headquartered in Newtown Square, AmeriHealth Caritas is a mission-driven organization with more than 30 years of experience. We deliver comprehensive, outcomes-driven care to those who need it most. We offer integrated managed care products, pharmaceutical benefit management and specialty pharmacy services, behavioral health services, and other administrative services. Discover more about us at www.amerihealthcaritas.com. **About this job:** The Regulatory Performance Sales Operations Manager develops and builds collaborative partnerships with internal teams, field marketing organizations (FMO), and vendors to serve as a resource for various regulatory requirements and compliance matters concerning sales operations. This role is part of the Retail Sales Operations Team and oversees federal and state-mandated readiness and oversight of FMO performance in meeting key performance indicators, including compliance expectations and requirements. Analyzes, interprets, presents, and communicates new and revised laws and provides regulatory guidance that affects the sales organization. Responsible for managing the implementation and oversight of sales operations and foundational and strategic compliance and regulatory responsibilities. **Responsibilities:** + Collaborate with business partners on interpreting readiness review requirements. This includes facilitating meetings and leading readiness. + Work closely with Medicare and Exchange compliance and operational teams. + Manage/oversee projects, initiatives, regulatory and performance, risk assessments, audit planning, and preparedness. + Establish project plans, gap analysis, milestone dates, other significant aspects, and leadership updates. + Maintain knowledge of laws, regulations, and company strategies to assess impact and consult as subject matter expert. + Conducts oversight and investigations, documents findings, and ensures corrective actions are made. + Scores and tracks contractual SLAs within the sales channel. + Oversees the ongoing development and maintenance of sales-related policies and procedures. + Responsible for managing and responding to internal compliance teams regarding sales allegations, complaints, CTMs, Unauthorized Plan Switching, and Corrective Action Plans. **Education & Qualifications:** + ;A bachelor’s degree is preferred, or equivalent experience is required. + 4 years of experience in the healthcare industry, ideally working with sales teams and FMOs. + 2 years of experience in compliance interpreting, understanding, and communicating regulations. + Ability to comprehend complex federal regulations and articulate them to internal stakeholders. + Excellent verbal and written communication skills with the ability to understand and articulate complex information to internal and external stakeholders. + Ability to consult with stakeholders on subject matter expertise and influence decisions appropriately. + Strong presentation skills, with the ability to disseminate information clearly and effectively. + Strong interpersonal skills with the ability to develop strong relationships of collaboration and trust. + Proficiency with Microsoft Office with the technical aptitude to learn new systems quickly **Diversity, Equity, and Inclusion** At AmeriHealth Caritas, everyone can feel valued, supported, and comfortable to be themselves. Our commitment to equity means that all associates have a fair opportunity to achieve their full potential. We put these principles into action every day by acting with integrity and respect. We stand together to speak out against injustice and to break down barriers to support a more inclusive and equitable workplace. Celebrating and embracing the diverse thoughts and perspectives that make up our workforce means our company is more vibrant, innovative, and better able to support the people and communities we serve. We keep our associates happy so they can focus on keeping our members healthy. **Our Comprehensive Benefits Package** Flexible work solutions include remote options, hybrid work schedules, competitive pay, paid time off, holidays and volunteer events, health insurance coverage for you and your dependents on Day 1, 401(k) tuition reimbursement, and more. As a company, we support internal diversity through: Recruiting. We are an equal opportunity employer. We do not discriminate on the basis of age, race, ethnicity, gender, religion, sexual orientation, or disability. Our inclusive, equitable approach to recruiting and hiring reinforces our commitment to DEI.
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