Regulatory Compliance Analyst

HealthEdge • Remote,

1d • $75,000 - $95,000 • Remote

About The Position

This position is responsible for supporting the organization and clients in meeting Federal and State regulatory requirements and customer contractual compliance obligations. The role supports compliance initiatives by monitoring regulatory sources, analyzing, distributing, and tracking regulatory communications related to Medicare and Medicaid healthcare programs. The role works cross-functionally with key stakeholders such as claims, enrollment, utilization management, risk adjustment, client success, product owners, vendors, and other areas to maintain adherence with CMS and state regulatory guidelines.

Requirements

• Bachelor’s degree in healthcare administration, public health or related field.
• Minimum of four (4) years of healthcare experience.
• Working knowledge of Medicare, Medicaid, and ACA health plan regulations along with related federal and state laws.
• Strong interpersonal skills and the ability to collaborate with colleagues at all levels.
• Excellent analytical, organizational, and communication skills.
• Ability to prioritize and manage multiple cross-functional priorities.
• Proficiency in Microsoft Excel, Word, PowerPoint, and tracking/reporting tools.

Nice To Haves

• Certification in healthcare compliance (CHC) preferred
• Experience in managed care, healthcare operations, or regulatory compliance preferred.

Responsibilities

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

What This Job Offers

• Job Type: Full-time
• Career Level: Mid Level