Executive Advisor, Enterprise Risk and Regulatory Affairs

About the role

The Executive Advisor, Enterprise Risk and Regulatory Affairs (EAERRA) will lead efforts to identify, assess, and manage risks impacting ForHealth Consulting. This role will provide strategic guidance to the ForHealth Consulting leadership team relating to risk management, contracting, government compliance, operational matters, and business growth opportunities.

Responsibilities

• Provide advice and guidance relating to risk assessment and management, corporate and contracting matters, business and product development, regulatory issues, and data privacy and security.
• Ensure delivery of practical advice that is pragmatic, business-minded, risk-based, and data-driven.
• Provide review and risk analysis of internal processes, procedures and related documentation; support effective implementation of new or improved programs, policies, and business processes according to organizational goals, industry trends, and applicable laws and regulations.
• Provide advice and risk analysis on various business structures and contracting options for services provided by ForHealth Consulting for clients; assess various contractual instruments to best support ForHealth Consulting's operations, clients, and partners.
• Actively participate in new product development, including evaluation of emerging federal and state regulatory developments to assess market opportunities and pathways.
• Collaborate closely with business unit members, finance, legal functions to evaluate external opportunities, develop business cases, manage the due diligence process, and ensure internal stakeholder alignment.
• Participate in negotiations with potential clients, business partners, and vendors to efficiently capture new contracts, grow existing contracts, and generate follow-on opportunities for future contracts; serve as a member of client engagement team when regulatory or contractual changes are part of the service offering.
• Remain current on industry, business and legal developments and specific regulations that may impact ForHealth Consulting's operations or service offerings to ensure ongoing compliance while reducing risk; maintain a comprehensive knowledge of state and federal laws related to Medicaid and Medicare, finance and appropriations, and public procurements.
• Contributes to delivery of client facing work product relating to public policy, regulatory or legislative consulting engagements and serve on project teams as needed.
• Support external visibility and connectivity by participating or presenting in both internal and external forums to ensure that ForHealth Consulting is considered the partner of choice.

Qualifications

• Undergraduate degree required. Graduate or professional degree, advance degree preferred (MBA or JD).
• At least ten years of full-time, or equivalent part-time, professional experience in health care business, law or government.
• This work experience can have been acquired through work directly with health care organizations or government agencies or institutions of similar stature as ForHealth Consulting, including consulting or law firms.
• At least five years experience must have been in a leadership role or as a trusted advisor supporting organizations or executives in making impactful business decisions that promote growth while limiting risk.
• Comprehensive knowledge of federal and state law, rules, and regulations that impact both public sector and private health care system clients; extensive policy, operational, and technical expertise implementing the Centers for Medicare & Medicaid Services (CMS) and other federal requirements related to Medicare, Medicaid, the Childrens Health Insurance Program (CHIP), and the Marketplace.
• Knowledge of health care challenges and trends; health care industry experience and familiarity with state and federal health care payment models and mechanisms preferred.
• Experience in interpretation and analysis of health policy, state and federal regulations, rules and legislation.
• Demonstrated skills and experience in counseling clients, research and analysis, oral and written advocacy, and creative problem solving; litigation or transactional legal experience preferred.
• Strong interpersonal and communication skills, and the ability to effectively manage multiple projects simultaneously.
• Deep understanding of key drivers of value for transactions and how they can be measured and quantified; outstanding analytic and strategic skills.
• Strong influencing skills and organization savvy to effectively interact with multiple internal stakeholders and drive interactions with external partners to evaluate and execute on collaboration and externalization of novel ideas and assets.
• High tolerance for ambiguity and ability to influence processes (internally and externally) must be demonstrated.
• Demonstrated experience with all phases of business development; specific transactional experience in the healthcare industry is preferred.