Regulatory Analyst, Sr

Regal Medical Group • Los Angeles, CA

5d • $29 - $31

About The Position

The Sr. Regulatory Analyst will communicate with Information Technology (IT),
Heritage Provider Network Clinical Services (HPN CS) and other departments
within the organization to become an expert on Regulatory Health Plan
Utilization Management (UM) correspondence templates for all lines of
businesses. The Senior Analyst will also serve as a mentor and will monitor the
workflow of the Analyst I as well as serve as the oversight with the letter
testing process.

Requirements

• BA/BS degree preferred
• Strong analytical, creative problem solving, and organizational skills
• Exemplary verbal and written communication skills
• Ability to strategize effectively, execute within timelines, and deliver quality results
• Ability to thrive in a fast-paced environment where flexibility and being proactive are essential
• 0-5 years of professional experience
• Experience with data analysis and high proficiency in Excel, Word, and Adobe
• Ability to work in multi-task environment
• Must be able to handle multiple projects at one time, reset priorities day-to-day to meet deadlines, and know when to ask for assistance and direction when working with conflicting priorities
• Must have the ability to work with all levels of management and have the ability to develop positive working relationships with company department heads

Responsibilities

• Perform secondary reviews of letter testing conducted by Analyst I, ensuring adherence to departmental procedures.
• Assist in and ensure accuracy and timeliness of SharePoint uploads through secondary review processes.
• Act as a mentor and participate in training initiatives for Analyst I.
• Examine letters returned from HPN with errors, and coordinate with IT and Analyst I for necessary corrections.
• Coordinate the finalization and submission of letter templates to HPN Corporate.
• Oversee the management of pending letters in HPN’s Smartsheet for assigned health plans.
• Manage and maintain the P Drive, ensuring it is up-to-date with current letter templates.
• Participate in scheduled meetings and provide regular updates on the status of assigned health plans.
• Serve as the primary contact for inquiries related to letter issues between IT and the Letters Team.
• Provide assistance in addressing audit inquiries concerning health plan templates.
• Identify improvement opportunities in letter testing processes for Analyst I and the broader testing framework.
• Proactively detect and escalate potential compliance issues.
• All other duties as directed by management.

Benefits

• full range of medical, financial, and/or other benefits (including 401(k) eligibility and various paid time off benefits, such as vacation, sick time, and parental leave)

What This Job Offers

• Job Type: Full-time
• Career Level: Mid Level
• Number of Employees: 501-1,000 employees