Government Programs Policy Specialist / NYC - RCM Health Care Services : Job Details

Job Description Please Do Not Apply Unless You Meet All of the Following:

Bachelor's Degree in a related field.

3-5 years of Medicaid or Medicare Managed Care or Managed Care Special Needs Plan experience.

5+ years of demonstrated experience researching, reviewing, and interpreting laws and regulations with Medicare/Medicaid.

Government Programs Policy Specialist / Mostly Remote / NYC Job Type: Full-Time, Permanent Location: Primarily Remote - In-office presence in NYC only as needed for key meetings or collaboration Schedule: Monday through Friday, Standard Business Hours Salary Range: $86,000 - $95,000 Government Programs Policy Specialist Position Overview We are seeking a Government Programs Policy Specialist to support compliance and regulatory efforts within a mission-driven health plan. This role is responsible for conducting in-depth regulatory research, tracking legislative changes, and guiding internal teams through the implementation of evolving government program requirements. While primarily remote, this position may require occasional in-office attendance in New York City for important meetings or collaborative projects. Government Programs Policy Specialist Key Responsibilities

• Monitor, interpret, and distribute a high volume of regulatory updates, laws, and guidance affecting specific business units.
• Assess the impact of pending legislation and regulations on organizational operations and compliance.
• Partner with internal departments to coordinate the implementation of new regulatory and legislative changes.
• Conduct timely research to respond to regulatory questions related to processes, policies, and procedures.
• Provide clear guidance on regulatory and contractual obligations across various lines of business.
• Support the development and periodic review of compliance policies and procedures.
• Contribute accurate, timely data and analysis for Compliance Committee and Board Subcommittee reports.
• Develop work plans and monitor progress for projects tied to regulatory requirements.
• Perform additional duties as assigned.

Government Programs Policy Specialist Qualifications

• Bachelor's degree required.
• Minimum 5 years of experience in regulatory research and interpretation.
• 3-5 years of experience in Medicaid Managed Care or Special Needs Plans.
• Demonstrated success working with regulatory agencies on audits, reporting, and compliance matters.
• Strong project management skills with the ability to handle complex initiatives and meet deadlines.
• Effective communicator with the ability to translate complex regulations into clear operational guidance.
• Proficient with research tools such as LexisNexis and Westlaw, and Microsoft Office (Word, Excel, PowerPoint, SharePoint).