Manager, Regulatory & Payer Operations Support

About the role

The Manager, Regulatory & Payer Operations Support leads the Regulatory & Payer Operations Specialist team, ensuring regulatory readiness, payer operations excellence, audit support, and compliance across multiple locations.

Key responsibilities

• Lead, coach, and develop Regulatory & Payer Operations Specialists.
• Manage staffing, performance evaluations, training, and workforce planning.
• Ensure office survey readiness and compliance with CMS, Medicaid, accreditation, licensing, and company requirements.
• Monitor regulatory and payer changes and coordinate implementation activities.
• Oversee insurance verification, benefits investigation, and prior authorization support.
• Escalate and resolve complex payer, eligibility, authorization, and reimbursement issues.
• Direct audit response coordination and medical record retrieval efforts.
• Develop operational metrics, reporting, and performance dashboards.
• Partner with Revenue Cycle, Compliance, Operations, Credentialing, and Payer Relations leadership.

Required profile

• Minimum 5 years of experience in healthcare reimbursement, payer operations, regulatory affairs, compliance, revenue cycle, or healthcare operations.
• Minimum 2 years of leadership experience.
• Minimum 2 years of DME experience.
• Experience managing audits, compliance programs, or payer operations functions.
• Knowledge of Medicare, Medicaid, and commercial payer processes.
• Strong communication, analytical, organizational, and project management skills.
• Proficiency in Microsoft Office applications.

What we offer

• Comprehensive medical, dental, and vision insurance, wellness programs, and mental health resources.
• Competitive 401(k) plan with immediate company match and financial planning services.
• Generous paid time off, flexible work hours, and hybrid work arrangements.
• Professional development opportunities, mentorship, tuition reimbursement, and training programs.
• Recognition programs, bonuses, awards, and special events.
• Community involvement, volunteer opportunities, and sustainability initiatives.
• Salary range $95,898 – $143,847 per year, with potential bonuses and incentives.