Waiver Contract Manager

Waiver Contract Manager Company: Vaya Health Location: Remote – North Carolina (must live in NC or within 40 miles of the NC border) Base pay range: $107,960.37/yr - $140,348.48/yr General Statement of Job: The Waiver Contract Manager serves as the Contract Manager for Vaya Health’s contracts with the NC Department of Health and Human Services (the “Department”). This position is the designated point of contact with the Department and the primary liaison with Department staff. The position is responsible for driving implementation of, and continued compliance with, all pertinent regulatory and contractual requirements applicable to Vaya’s managed care operations. Essential Job Functions Serves as primary liaison with the NC Department of Health and Human Services on all contractual and regulatory matters, including 1115 Waiver, 1915(i) SPA, and 1915(c) Waivers. Attends and participates in regular and ad hoc committee meetings with Department staff; takes careful and detailed notes, tracks action items, and reports to Vaya SMEs and leadership on emerging issues and areas of concern. Proactively alerts the Area Director, CEO, and General Counsel & Chief Compliance Officer of emerging risks related to Vaya’s contractual performance or relationships with NCDHHS staff. Develops and maintains excellent working relationships with Department officials and collaborates with waiver contract managers at other NC managed care organizations to develop common positions and promote LME/MCO interests. Monitors and records all communications to/from the Department through the Waiver Contract mailbox; timely distributes communication bulletins, proposed contract amendments, allocation letters, and other regulatory materials received from the Department to SMEs and responsible staff; maintains the internal SharePoint folders where NCDHHS regulatory materials are stored and tracked. Timely responds to inquiries and data requests from Department officials and provides guidance to Vaya staff on Waiver Contract requirements; collaborates with the VP of Public Affairs as needed to respond to legislative inquiries. Acts as primary owner and utilizer of the Department’s PHP Contract Data Utility (PCDU) system, ensuring timely uploads of deliverables and distributions of downloaded information; works with the Performance Reporting Director to ensure all contractual reports are submitted timely through the PCDU. Provides oversight of internal monitoring of and responding to tickets entered in the Department’s Service Now ticketing system, including supervision of the Ticketing Specialist. Monitors the regulatory environment and works with the Legal Department to assess and communicate the impact of new and changing laws, rules, regulations, and Department contract requirements on the organization. Supports the External Review Director with all external reviews as needed. Participates in the development, implementation and maintenance of regulatory processes organization-wide with a primary emphasis on compliance with Waiver Contract requirements, including the annual External Quality Review. Supports the Regulatory Compliance Team with the development, implementation and revisions of Vaya Standard Operating Procedures to improve efficiencies, ensure compliance with regulatory requirements, and foster a culture of departmental self‑determination. Serves on internal Vaya committees and workgroups and partners with other departments to ensure alignment of regulatory strategy and plans with organizational objectives. Knowledge, Skills, & Abilities Excellent oral and written communication skills and interpersonal skills, including active listening. Strong interpersonal skills; ability to interact with all levels of leadership and management. Demonstrated ability to build consensus and effect change. Ability to assist in projects, motivate and influence others, and move toward a common vision or goal. Creative and strategic thinking in a constantly evolving environment. Proactive identification and resolution of concerns. Strong analytical and problem‑solving skills; demonstrated critical thinking and decision‑making ability. Strong organizational and research skills with proven attention to detail. Good judgment and ability to manage competing priorities. Intermediate to advanced proficiency with Microsoft Office Suite (Excel – pivot tables, graphs, charts; Word; PowerPoint). Highly motivated, team player, self‑starter, able to work independently with little or no direction; permitted to work from home as needed with supervisory approval. Familiarity with approaches and strategies for evaluating organizational constructs. Resourceful with ability to quickly achieve a basic working knowledge of operations of each internal department. Excellent grasp of federal and state laws, rules, regulations, standards, guidelines and policies governing Vaya and overall service delivery system, including basic privacy, security and confidentiality requirements applicable to a health plan. Sound understanding of North Carolina Medicaid Managed Care. Education & Experience Requirements Bachelor’s degree in Business or a health and human services related field required; Master’s preferred. Minimum seven years of health‑care related management experience (or comparable experience with a State Medicaid agency or State mental health agency) and at least two years of experience in risk management, accountability, compliance, or quality management activities. Licensure/Certification Preferred Certified in Healthcare Compliance (CHC) preferred. Physical Requirements Close visual acuity needed for preparation, analysis of documents, computer use, and reading. Physical activity includes crouching, reaching, walking, talking, hearing and repetitive motion of hands, wrists and fingers. Sedentary work with lifting up to 10 pounds, sitting for extended periods. Mental concentration required in all aspects of work. Residency Requirement The person in this position is required to reside in North Carolina or within 40 miles of the North Carolina border. Salary Depends on qualifications and experience. This position is exempt and is not eligible for overtime compensation. Benefits Medical insurance Vision insurance 401(k) Pension plan Disability insurance Apply Vaya Health accepts online applications through our Career Center, please visit Vaya Health is an equal opportunity employer. #J-18808-Ljbffr