Virginia Premier Health Plan, Inc.

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Manager, Regulatory Reporting

Manager, Regulatory Reporting

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Job Description


This position is responsible for developing an extensive expertise in the corporate data systems. Responsible for gathering requirements, performing analysis, supporting the development and testing of reporting, and understanding the applications, data, and associated technologies for supported areas.


The Regulatory Reporting Manager is additionally responsible for the build, upkeep, maintenance, and validity of all Regulatory Reporting for Virginia Premier Health Plan lines of businesses. This position will work closely with all internal departments and leverage business knowledge and specific regulatory business requirements to drive the creation and implementation of the reporting.  They will work closely with Program Integrity and Compliance, departmental business owners and regulatory agencies to ensure understanding of requirements are fully vetted and that the reporting accurately reflects requirements.


  • Support Director of Finance and lead a team of analysts in the development and execution of regulatory reporting requirements for CMS, DMAS and other regulatory entities as required.
  • Design and maintain data structures and systems related to regulatory and other reporting.
  • Coordinate the training and growth of new analysts, and facilitate their growth within the company.
  • Monitor changes in the external environment (regulatory/reimbursement changes, managed care arrangements, etc.) and advise senior management on threats and opportunities with suggested action plans.
  • Assist in development and establishment of benchmarks and benchmark reporting.
  • Participate in development teams  and analysis efforts with other managers (including managers of other organizations)
  • Coordinate with Compliance and Program Integrity to ensure timely submission of all reports
  • Work closely with Finance Program managers to develop, implement and operationalize regulatory reports




  • Required: Bachelors Degree in Business, Health Administration, Mathematics, Information Systems,  or related field
  • Desired: Masters or other advanced degree (MBS, MIS, or other)


  • Strong project management skills.
  • Significant attention to detail.
  • Strong analytical and prioritization skills with the ability to manage several projects simultaneously.
  • Highly analytical thinking with demonstrated talent for identifying, scrutinizing, improving, and streamlining complex work processes
  • Must be able to perform under pressure and in a very dynamic environment
  • Have a high degree of initiative, motivation and passion for the business.
  • Excellent interpersonal skills and strong strategic management skills.
  • Work, direct, and take direction with all levels of management
  • Perform in a diverse cross-functional team environment.
  • Advanced personal computer skills, including experience with Microsoft Office.
  • Ability to analyze complex problems and develop multiple workable solutions
  • Demonstrates an active interest in enhancing current skills and learning new ones; applies advanced functional or technical knowledge to do his or her job at a high level of accomplishment
  • Chooses appropriate tools or technology for tasks; improves or redesigns processes, tools, or technologies to determine applicability
  • Highly skilled in writing queries that join multiple data sources and complex data manipulation
  • Consistently shares expertise with others, teaching skills and explaining concepts
  • Leads analytical team.  May lead multi-functional teams.
  • Coaches and mentors others
  • Demonstrated experience in troubleshooting complex problems
  • Organized, on-time, and displays an energized attitude


  • Required: Minimum 3+ years of experience in data analysis and/or report development
  • Preferred: Minimum 3+ years of experience in healthcare (preferably Medicaid (and/or) Medicare), business analysis or application development/implementation
  • Six Sigma Green Belt preferred.


  • Physical health sufficient to meet the ergonomic standards and demands of the position.

About Us

Virginia Premier Health Plan, Inc. is a managed care organization which began as a full-service Medicaid MCO in 1995. Partnered with VCU Medical Systems we strive to meet the needs of the underserved and vulnerable populations in Virginia by delivering quality driven, culturally sensitive and financially viable Medicare and Medicaid healthcare programs.  Headquartered in Richmond, VA we also have offices in Roanoke, Tidewater and Bristol with additional satellite locations allowing us to serve over 200,000 members across eighty counties throughout Virginia. 


We offer competitive salaries and a comprehensive benefits package to include excellent Medical, Dental and Vision Plans, Tuition Assistance, Infant-At-Work Program, Remote Work options and generous vacation and sick leave policies. Our culture supports an environment where employees can continuously learn and gain professional growth through various development programs, education, exciting projects and career mobility.  


All qualified applicants will receive consideration for employment without regard to age, race, color, religion, sex, sexual orientation, gender identity, national origin, disability, or protected veteran status. EOE


Our mission is to inspire healthy living within the communities we serve!

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