GOVERNMENT AFFAIRS & HEALTH POLICY LEAD in San Juan at TPIS

Regular/Exempt Position

GENERAL DESCRIPTION

Our client, a leading healthcare organization, is seeking a strategic and highly analytical professional to serve as Lead, Government Affairs & Health Policy. This role requires deep expertise in healthcare policy, government affairs, healthcare economics, and regulatory strategy.

The selected candidate will lead the evaluation, development, and implementation of policy initiatives that impact Medicare Advantage and Commercial health plan operations. This individual will serve as a trusted advisor to executive leadership, translating complex regulatory, legislative, and economic developments into actionable business strategies that support organizational growth, compliance, financial sustainability, and market competitiveness.

ESSENTIAL FUNCTIONS

• Lead the organization's government affairs and health policy initiatives, ensuring alignment with strategic goals and business priorities.
• Develop and execute integrated policy strategies that support Medicare Advantage and Commercial business operations.
• Analyze the financial and operational impact of healthcare policy, regulatory, and reimbursement changes, providing strategic recommendations to leadership.
• Conduct economic and market assessments to support long-term planning, growth initiatives, and organizational decision-making.
• Monitor legislative, regulatory, and healthcare industry developments and proactively identify risks and opportunities.
• Direct research and analysis related to federal, state, and local healthcare regulations, translating findings into business implications and strategic actions.
• Collaborate with cross-functional leadership teams to ensure regulatory requirements are incorporated into business planning and execution.
• Lead the development of policy positions, regulatory responses, comment letters, and other formal communications related to healthcare legislation and reform initiatives.
• Establish and maintain effective relationships with government agencies, regulatory bodies, policymakers, healthcare associations, and industry stakeholders.
• Prepare executive-level briefings, presentations, and strategic recommendations regarding healthcare policy trends and their impact on organizational performance.
• Support initiatives related to product strategy, reimbursement methodologies, risk adjustment, value-based care, and population health management.
• Serve as a subject matter expert on healthcare economics, regulatory compliance, and public policy matters affecting the healthcare industry.

• Bachelor's Degree in Economics, Health Services Administration, Public Policy, Healthcare Management, or a related field required.
• Master's Degree preferred.

• Minimum of five (5) years of experience in government affairs, healthcare policy, healthcare strategy, public policy, regulatory affairs, or related disciplines.
• Strong experience analyzing healthcare regulations, economic impacts, and policy implications within highly regulated environments.
• Experience supporting Medicare Advantage, Commercial health plans, or payer organizations is strongly preferred.

• Advanced knowledge of healthcare policy, government affairs, reimbursement systems, and regulatory frameworks.
• Strong understanding of Medicare Advantage, Commercial health insurance markets, and healthcare financing models.
• Expertise in economic analysis, policy impact assessment, and strategic planning.
• Exceptional analytical, critical thinking, and problem-solving skills.
• Ability to synthesize complex information and communicate recommendations to executive leadership.
• Strong relationship-building, negotiation, and stakeholder management capabilities.
• Excellent written and verbal communication skills, including executive presentations and policy documentation.
• Proven ability to manage multiple priorities in a fast-paced and evolving regulatory environment.

• Proficiency in data analysis, financial modeling, reporting, and presentation tools.
• Strong Microsoft Office skills, including Excel and PowerPoint.

• Fully bilingual in English and Spanish (written and verbal).

TPIS is an Equal Opportunity Employer (EEO Employer / Affirmative Action for Females / Disabled / Veterans). We comply with all Federal, State and Local laws regarding nondiscrimination.