Director, Regulatory Affairs

The Massachusetts League of Community Health Centers (League) was founded in 1972 as one of the country's first state Primary Care Associations (PCAs). Established under the same federal authorizing legislation as the health center program (Section 330 of the Public Health Service Act), PCAs are organized around a set of core functions and competencies that provide a framework for support and assistance to health centers and the communities they serve. The League is a non-profit 501(c)(3) organization registered as a public charity with the Secretary of the Commonwealth. It maintains a professional staff at its headquarters in Boston and its training center in Worcester.

Position Summary:

The Director, Regulatory Affairs will serve as the subject matter expert within the Government Affairs and Public Policy team on federal and state regulatory policy impacting health center organizations, patients, and communities. This position is a unique opportunity to help shape health policy to ensure health centers continue to provide high quality, equitable primary care in underserved communities across the Commonwealth. Working under the direction of the Vice President of Regulatory Affairs, the Director anticipates, analyzes and translates federal and state regulatory policy changes, with a particular focus on health center payment/ reimbursement. The candidate will also provide leadership on payment transformation efforts by MassHealth and other payers, following national and local trends and providing in-house subject matter leadership.

Essential Functions: This role requires a candidate who has the ability to:

Regulatory Policy

• Monitor and assess proposed and finalized rules, regulations, bulletins and other provider guidance issued by federal (e.g., CMS, HHS, SAMHSA) and state (e.g., EOHHS, MassHealth, DPH) agencies that impact health centers, their patients, and the communities they serve. Topics include but are not limited to Medicare and Medicaid payment/ reimbursement, billing and provider enrollment and credentialing.
• Analyze and distill complex regulatory policy and its implications into clear, concise, and actionable language that meets the needs of different audiences and ensure timely communication of changes to members.
• Draft and submit testimony and comment letters on new and revised regulatory policy. Gather feedback from health center members and other partners/ stakeholders to inform content as needed/ appropriate.
• Serve as a subject matter expert on federal and state regulatory policy and develop memorandums and policy briefs for internal Mass League staff and member education.
• Maintain expertise on health center payment/ reimbursement policy and operations, including Medicare, MassHealth (Medicaid), the Health Safety Net, and commercial payers in support of and in collaboration with the VP, Regulatory Affairs.
• Identify emerging regulatory issues and trends affecting health centers and elevate significant concerns, opportunities, and policy implications to the VP, Regulatory Affairs.
• Support Payment Transformation and CHC Financial Sustainability. Track and analyze payment and reimbursement transformation initiatives, including Medicare and MassHealth, and assess their operational and financial implications for community health centers. Support health centers in understanding and implementing payment and reimbursement changes, identifying opportunities to improve revenue and operational efficiency, and mitigating financial and operational risks associated with payment transformation.
• Work to support cross-divisional education and alignment on key regulatory policy and training and technical assistance needs to best support health centers.
• Provide subject matter expertise and input on state legislative and budgetary priorities and maintain status as registered lobbyist.

Regulatory Implementation and Compliance

• Support health centers in understanding applicable federal and state rules, regulations, bulletins, and other provider guidance, including providing training and technical assistance on implementation and compliance.
• Monitor emerging health center compliance and program integrity issues and identify trends that may require broader Mass League education, technical assistance, or policy engagement.
• Lead education, training, and technical assistance for health centers on payment/ reimbursement and billing, including facilitating the Lead Billers Forum and FQHC Billing Workgroup. Track health center payment/ reimbursement and billing issues and work with necessary partners/ stakeholders to resolve in a timely manner.
• Support health centers in navigating regulatory and program integrity questions involving billing, reimbursement, provider enrollment, credentialing, and related requirements. Partner with the VP, Regulatory Affairs to identify recurring compliance and implementation challenges that may warrant engagement with state or federal agencies or inclusion in broader regulatory advocacy.
• In partnership with the VP, Regulatory Affairs, work with MassHealth, the League's Special Workgroup on Payment, and health centers on prioritizing, finalizing, and implementing outstanding PPS and payment workstreams.
• Support the development of an array of training and technical assistance vehicles for various levels of health center stakeholders including written materials, webinars, and standing committees/meetings (including CFO Peer to Peer, CFO Forum, Governmental Affairs Committee) to provide timely information and support regarding health center regulatory policy changes.
• Monitor assigned communication and query resources, including Higher Logic, standing TA calls, etc., coordinating and providing answers to all questions related to health center billing and payment.

Committees & External Affiliations

• Serve as a primary GAPP staff resource for health center member questions related to regulatory policy, implementation and compliance, health center payment/ reimbursement, and billing.
• Lead the Lead Billers Forum and FQHC Billing Workgroup and support the CFO Forum, COO Forum, and other standing member forums as assigned.
• Represent the GAPP team on staff committees within the Mass League and represent health centers and the Mass League on external partner organizations.
• Collaborate with state agencies, federal agencies, national associations, and other stakeholders to address regulatory policy, technical and operational barriers affecting health centers.

Competencies/Skills:

• Prior experience working with health care organizations that focus on vulnerable populations.
• Demonstrated presentation, facilitation and leadership skills.
• Detail-oriented and demonstrated competency in project management.
• Strong interpersonal skills including ability to establish and maintain effective relationships with partners, providers, administrators, and staff.
• Strong strategic thinking, assessment and analytic skills.

Education/Experience:

• Master's degree in public policy, public health, law, health care administration, or a related field is preferred; comparable work experience will be considered.
• Minimum 5 years work experience in health policy, government affairs, health care administration or related fields.

The Massachusetts League of Community Health Centers is an equal opportunity employer committed to a workplace that reflects the diversity of the people of Massachusetts, including populations most impacted by health inequities.

It is the policy of the Massachusetts League of Community Health Centers to provide equal employment opportunity to all employees and applicants for employment without regard to race, sex, sexual orientation, gender identity or expression, color, creed, religion, national origin, age, disability, marital status, parental status, family medical history or genetic information, political affiliation, military service or any other non-merit based factor in accordance with all applicable laws, directives and regulations of federal, state and city entities