Regulatory Compliance Operations Liaison

Sedgwick

2d • $75,000 - $90,000 • Hybrid

About The Position

By joining Sedgwick, you'll be part of something truly meaningful. It’s what our 33,000 colleagues do every day for people around the world who are facing the unexpected. We invite you to grow your career with us, experience our caring culture, and enjoy work-life balance. Here, there’s no limit to what you can achieve. Newsweek Recognizes Sedgwick as America’s Greatest Workplaces National Top Companies Certified as a Great Place to Work® Fortune Best Workplaces in Financial Services & Insurance Regulatory Compliance Operations Liaison Are you looking for an opportunity to join a global industry leader where you can bring your big ideas to help solve problems for some of the world’s best brands? Deliver innovative customer-facing solutions to clients who represent virtually every industry and comprise some of the world’s most respected organizations. Be a part of a rapidly growing, industry-leading global company known for its excellence and customer service. Leverage Sedgwick’s broad, global network of experts to both learn from and to share your insights. Take advantage of a variety of professional development opportunities that help you perform your best work and grow your career. Enjoy flexibility and autonomy in your daily work, your location, and your career path. Access diverse and comprehensive benefits to take care of your mental, physical, financial and professional needs. PRIMARY PURPOSE OF THE ROLE: The Regulatory Compliance Operations Liaison serve as a key coordination point between Clinical Operations, Legal, Compliance, Licensing, and business stakeholders to support alignment with regulatory, accreditation, and jurisdiction requirements. This role interprets regulatory updates and translates them into clear operational guidance, supports utilization review and clinical pharmacy compliance activities, coordinates audit and accreditation readiness, and helps ensure regulatory communications, documentation, appeals, complaints, and operational processes are accurate, consistent, and appropriately vetted.

Requirements

• Six (6) years of related experience or equivalent combination of education and experience required.

Nice To Haves

• Bachelor's degree from an accredited college or university preferred.
• Licenses as needed.

Responsibilities

• Interprets regulatory updates and compliance guidance and translates requirements into clear, actionable direction for Clinical Operations, Utilization Review, Pharmacy Operations, and related business teams.
• Partners with operational leaders to assess workflows against established policies, procedures, jurisdictional requirements, and accreditation standards; identifies gaps and recommends process improvements.
• Supports implementation and communication of regulatory, accreditation, and compliance-related changes across assigned clinical programs
• Serves as a liaison between Utilization Review, Pharmacy Operations, Legal, Compliance, Licensing, Claims, and other stakeholders to ensure communications, processes, and responses are appropriately reviewed and aligned.
• Supports utilization review regulatory inquiries, including appeals, complaints, audit requests, and other regulatory responses; manages and triages the Utilization Review Compliance mailbox to ensure timely routing, tracking, follow-up, and response.
• Maintains documentation, tracking logs, audit trails, and centralized records to support regulatory readiness, compliance oversight, and operational accountability; identifies and escalates compliance, licensing, regulatory, audit, appeal, complaint, or documentation risks to appropriate leadership.
• Coordinates and supports state-level utilization review appeals in collaboration with Claims, Clinical Operations, Legal, Compliance, and other appropriate stakeholders.
• Leads or supports development and maintenance of regulatory correspondence, standard letter templates, SOPs, operational documentation, and compliance-related communications.

Benefits

• Flexible work schedule.
• Referral incentive program.
• Opportunity to work in an agile environment.
• Career development and promotional growth opportunities.
• A diverse and comprehensive benefits offering including medical, dental vision, 401K on day one.
• medical, dental, vision, 401k and matching, PTO, disability and life insurance, employee assistance, flexible spending or health savings account, and other additional voluntary benefits.

What This Job Offers

• Job Type: Full-time
• Career Level: Mid Level
• Education Level: Associate degree