Description

Position Summary

Driscoll Health Plan (DHP) is seeking a highly skilled and strategic Director of Regulatory Operations to lead and oversee the organization’s regulatory compliance and operational oversight functions. This role serves as a key liaison between DHP and state and federal regulatory agencies and provides expert guidance to internal stakeholders regarding managed care regulations, contractual obligations, audits, and regulatory reporting requirements.

The ideal candidate will bring strong legal, regulatory, or compliance experience within healthcare, managed care, or health plan operations and possess the ability to interpret complex regulations and drive operational compliance initiatives across the organization.

Key Responsibilities

• Serve as the subject matter expert on state and federal managed care regulations impacting DHP operations.
• Monitor, interpret, and communicate updates to the Texas Uniform Managed Care Contract (UMCC) and Uniform Managed Care Manual (UMCM).
• Lead and oversee delegated oversight programs, including audits, monitoring activities, corrective action plans, and remediation efforts.
• Direct the preparation, tracking, and submission of regulatory filings, audits, and reports to agencies including:
  • Texas Health and Human Services Commission (HHSC)
  • Texas Office of Inspector General (OIG)
  • Texas Department of Insurance (TDI)
• Build and maintain collaborative relationships with regulatory agencies and external stakeholders.
• Represent DHP during regulatory meetings, audits, and industry association collaborations including TAHP and TACHP.
• Oversee contract management processes and regulatory response coordination.
• Mentor and develop regulatory staff while promoting operational excellence and cross-functional collaboration.
• Support organizational leadership by providing regulatory guidance that informs strategic and operational decision-making.

Qualifications

• Bachelor’s degree required.
• JD, Paralegal Certificate, or equivalent legal/regulatory training strongly preferred.
• Experience in healthcare regulatory compliance, managed care, health plan operations, government programs, or legal/regulatory affairs preferred.
• Strong understanding of healthcare regulatory frameworks, audits, compliance oversight, and contract management.
• Excellent communication, leadership, analytical, and relationship-management skills.
• Ability to manage multiple priorities in a fast-paced, highly regulated environment.

Why Join Driscoll Health Plan?

At Driscoll Health Plan, you will play a critical leadership role supporting healthcare operations that positively impact communities across Texas. This is an opportunity to work collaboratively with executive leadership, regulatory agencies, and cross-functional teams in a mission-driven organization committed to excellence and compliance.