Sr. Regulatory Compliance Analyst – Medicaid / Medicare | CareCentrix

As a Sr. Regulatory Compliance Analyst, responsible for monitoring regulatory requirements affecting CareCentrix government program operations, analyzing and documenting those requirements, communicating and educating affected business areas about those requirements, developing training programs to ensure an understanding of those requirements, and working with affected business areas to modify operations and policies and procedures to ensure compliance.

 

In this role you will:

  • Monitor federal and state laws impacting CareCentrix’s government program operations, analyze the information, and prepare and circulate written communications to affected business areas regarding such laws.


     
  • Provide support, guidance and direction in the development of policies, procedures, and other operational changes necessary to comply with legal requirements and support the operational areas in the implementation of such policies, procedures, and other changes as required.


     
  • Create and implement compliance tracking, trending, and reporting tools.
  • Perform internal audits as needed and identify opportunities for improvement.
  • Develop and deliver training programs to ensure a clear understanding of compliance requirements.
  • Assist Director of Regulatory Compliance and Chief Compliance Officer as needed.
  • Adhere to and participate in the Company’s mandatory HIPAA privacy program / practices and Business Ethics and Compliance programs / practices.

Why you are going to love this role:


 

  • You enjoy working with teams by building trust, fostering positive relationships and partnering with a diverse group of people.
  • You like to move fast. You enjoy working through ambiguity and a changing market environment.
  • You have the ability to function in a fast paced environment with high volume work output.

 
 

You should reach out if:


 

  • You have a Bachelor’s Degree with a minimum of 5 years’ experience in a managed care setting.
  • You have thorough understanding of federal and state laws impacting health insurers and their delegated entities, including but not limited to, laws impacting utilization management, claims, and credentialing for governmental health plans (Medicare, Medicaid).
  • You are proficient in MS Office including PowerPoint, SharePoint, and Excel.
  • You have excellent legal research skills.

What we offer:


 

  • Full range of benefits including Health, Dental and Vision with HSA Employer Contributions and Dependent Care FSA Employer Match.
  • Generous PTO, 401K Savings Plan, Paid Parental Leave, free on-demand Virtual Fitness Training and more.
  • Advancement opportunities, professional skills training, and tuition Reimbursement
  • Great culture with a sense of community.

CareCentrix maintains a drug-free workplace.

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