Regulatory Compliance Analyst

Role overview

The Regulatory Compliance Analyst supports the organization and clients in meeting Federal and State regulatory requirements and customer contractual compliance obligations for Medicare and Medicaid healthcare programs. The role monitors and analyzes regulatory sources, communicates requirements to stakeholders, and tracks implementation and compliance risk resolution.

Responsibilities

• Monitor, interpret, and track CMS guidance including Final Rules, HPMS memos, and Federal Register communications impacting Medicare Advantage, Medicaid, and other programs
• Communicate state and federal requirements to internal and external clients
• Prepare reports on regulatory communications and regulatory change management activities
• Oversee and maintain the regulatory distribution process
• Partner with internal business, product, and compliance stakeholders to ensure CMS compliance and contract obligations
• Maintain regulatory tracking documentation and implementation timelines
• Track implementation activities and support resolution of identified compliance risks
• Support development of desk-level procedures, presentations, and training materials

Requirements

• Bachelor’s degree in healthcare administration, public health, or related field
• 4+ years of managed care, healthcare operations, or regulatory compliance experience
• Working knowledge of Medicare, Medicaid, and ACA health plan regulations and related federal/state laws
• Strong analytical, organizational, and communication skills; able to prioritize multiple cross-functional priorities
• Proficiency with Microsoft Excel, Word, and PowerPoint and tracking/reporting tools
• Strong collaboration and interpersonal skills

Nice to have

• CHC (Certified Healthcare Compliance) certification preferred

Work setup

• Remote (US); may require work across multiple time zones
• Full-time, permanent; exempt