RFI Manager

We're building a world of health around every individual , shaping a more connected, convenient and compassionate health experience.

The RFI Manager within the Payment Integrity Center of Excellence (PI COE) leads the team responsible for managing and responding to official requests for information from regulatory agencies, state departments, law enforcement, and internal stakeholders.

The role ensures that sensitive data and documentation are delivered accurately, on time, and in compliance with applicable requirements across multiple lines of business and jurisdictions.

The manager oversees the full lifecycle of each request, from intake and triage through coordination, review, and final delivery, with a strong focus on meeting turnaround time commitments and maintaining accountability across all RFI-related activities.

The manager leads a team of Senior Reporting Analysts, including staff with embedded remote notary credentials, and works closely with partners in Legal, Compliance, and Operations to maintain transparency and consistency in all responses.

Responsibilities and Requirements

• Minimum of three years managing regulatory request responses, compliance deliverables, or administrative operations supporting regulatory departments.
• Advanced knowledge of problem-solving and decision-making methods.
• 7–10 years of experience in managed care operations, compliance, regulatory affairs, or a related healthcare function.
• Strong analytical and problem-solving skills with experience in data analysis and process management.
• In-depth knowledge of regulatory standards, compliance requirements, and state-specific reporting obligations.
• Excellent communication and leadership skills.
• Experience testifying in court or formal legal proceedings, including depositions and regulatory hearings.
• Strong understanding of PHI and PII handling requirements, including HIPAA, CMS, and applicable state-specific guidelines.
• Proficiency with Microsoft Excel, SharePoint, and case management systems.
• Ability to work independently and collaboratively in a fast-paced environment.
• Experience supporting training, quality, or process improvement initiatives.

Preferred Qualifications

• Experience working with Medicaid and Medicare programs.
• Familiarity with state-specific regulatory reporting protocols and requirements.
• Prior experience in a regulatory response, compliance, or administrative operations role.
• Knowledge of claims processing, provider contracting, and credentialing workflows.
• Experience in project management or process improvement.
• Accredited Health Care Fraud Investigator (AHFI) credential.
• Remote Online Notarization (RON) credential or experience.

Education

• Bachelor’s degree in Criminal Justice, Healthcare Administration, Business, or a related field preferred.
• Equivalent professional experience and specialized training may be considered in place of a formal degree.

Work Environment

• We support a hybrid work environment.
• If selected and you live near a suitable work location, you may be expected to comply with the hybrid work policy.

Benefits

• Comprehensive benefits package designed to support the physical, emotional, and financial well-being of colleagues and their families.
• Medical, dental, and vision coverage, paid time off, retirement savings options, wellness programs, and other resources, based on eligibility.

Salary

• The typical pay range for this role is: $66,330.00 - $145,860.00