Compliance Analyst

Capital Health Plan•Tallahassee, FL

About The Position

Capital Health Plan is seeking a full-time Compliance Analyst for its Tallahassee, Florida team. The role supports the organization’s compliance program by coordinating regulatory surveillance, obligation tracking, training administration, routine monitoring, reporting, documentation, and audit-readiness activities. The analyst works under the day-to-day guidance of the Senior Compliance Analyst and the overall direction of the Director of Compliance, turning regulatory and operational information into accurate, organized, and timely work products that support implementation, oversight, decision-making, and regulatory response. The analyst reviews and routes CMS communications, Health Plan Management System memoranda, Federal Register actions, and related guidance; identifies deadlines and affected business areas; and maintains regulatory filing and obligation trackers. The position develops and maintains dashboards, scorecards, reports, databases, logs, shared folders, and evidence files; coordinates annual and new-hire compliance training; and performs routine monitoring and quality checks using approved procedures and sampling instructions. The role also supports policy and procedure lifecycle activities, corrective-action tracking, audits, delegated entity oversight, hotline and inquiry documentation, privacy and compliance matters, FWA investigations, work groups, committees, and special projects. The analyst collaborates with operational departments and external partners to obtain information, resolve tracking gaps, support deadlines, and maintain organized, secure, and retrievable documentation. Applicants must be able to pass a background check and drug screening test.

Requirements

Associate degree in business, health care administration, legal studies, public administration, information management, or a related field, or an equivalent combination of education and relevant experience; listed as preferred.
Two or more years of experience in compliance, health care, health plan operations, regulatory affairs, legal support, audit, quality, data reporting, or a comparable analytical or administrative role.
Experience maintaining databases, trackers, documentation, deadlines, and confidential records.
Ability to read, analyze, and summarize regulations, guidance, policies, procedures, technical materials, and business communications.
Ability to calculate, validate, reconcile, summarize, and present percentages, rates, ratios, totals, trends, and other compliance data.
Sound reasoning skills to organize facts, apply established criteria, identify exceptions or control gaps, document supportable conclusions, and escalate concerns.
Strong research, analytical, organizational, proofreading, and written communication skills, with close attention to accuracy and source documentation.
Proficiency with Microsoft 365 applications, including Word, Excel, PowerPoint, Outlook, Teams, and SharePoint, or comparable tools.
Ability to manage multiple assignments and recurring deadlines, follow through on open items, and communicate professionally with internal and external partners.
Ability to maintain confidentiality, exercise sound judgment, and protect documentation integrity.
Ability to learn CHP systems, terminology, policies, and regulatory processes, and work independently within assigned authority and collaboratively as part of a team.
Ability to pass a background check and drug screening test.

Nice To Haves

Experience working in HPMS, HIOS, HHS-RADV Audit Tool, MARx, SEED, and other CMS-sponsored issuer portals.
Experience in a regulated health care or health plan environment.
Familiarity with Medicare Advantage Prescription Drug Plans (MAPD), the Federally-facilitated Exchange (FFE)/Marketplace, corporate compliance, HIPAA privacy and security requirements, and federal and state regulatory oversight.
Associate degree in business, health care administration, legal studies, public administration, information management, or a related field, or an equivalent combination of education and relevant experience.

Responsibilities

Review and route CMS communications, Health Plan Management System memoranda, Federal Register actions, and related guidance.
Identify regulatory deadlines and affected business areas, and maintain regulatory filing and obligation trackers.
Develop and maintain dashboards, scorecards, reports, databases, logs, shared folders, and evidence files.
Coordinate annual and new-hire compliance training.
Perform routine monitoring and quality checks using approved procedures and sampling instructions.
Support policy and procedure lifecycle activities and corrective-action tracking.
Support audits and delegated entity oversight.
Document hotline and inquiry activity and support privacy and compliance matters and FWA investigations.
Support work groups, committees, and special projects.
Collaborate with operational departments and external partners to obtain information, resolve tracking gaps, support deadlines, and maintain organized, secure, and retrievable documentation.