Regulatory Compliance Specialist

$66,560 - $81,593/Yr

CorVel - Folsom, CA

Full-time - Mid Level

Remote - Folsom, CA

1,001-5,000 employees

Professional, Scientific, and Technical Services

About the position

The Regulatory Compliance Specialist is responsible for ensuring compliance with jurisdictional regulations within the designated department, mitigating potential legal and cost exposure for the company. This role involves recommending and implementing process and policy changes based on state regulation updates, acting as a representative of CorVel while interacting with various stakeholders. The position may also involve collaboration with leadership teams to ensure quality performance and regulatory guidance.

Responsibilities

• Provide technical and jurisdictional guidance to management, clients, and claims staff regarding complex regulatory items.
• Evaluate upcoming regulatory changes and communicate them to affected departments for timely updates.
• Act as a functional resource in partnership with the Manager for overall regulatory compliance of the assigned department.
• Conduct internal and external compliance reviews and audits.
• Travel to customer, claims, and employee sites as needed for meetings and training.
• Communicate regulatory requirements effectively and provide necessary training.
• Interpret and apply client network contracts to support medical bill review.
• Negotiate audits with state and national offices to achieve 100% compliance.
• Track and report assigned compliance outcomes and successes.
• Comply with safety rules and regulations during work hours.

Requirements

• Bachelor's degree or a combination of education and related experience.
• Minimum of 2 years' experience in compliance or regulatory background.
• Excellent written and verbal communication skills.
• Ability to assist management and team members in understanding regulatory requirements.
• Strong negotiation skills and ability to remain poised in stressful situations.
• Computer proficiency with MS Office, including Excel spreadsheets.
• Strong problem-solving and analytical skills.
• Great attention to detail and results-focused.

Nice-to-haves

• Ability to travel overnight and attend meetings if required.
• Effective quantitative, analytical, and interpretive skills.
• Strong interpersonal, time management, and organizational skills.

Benefits

• Medical (HDHP) with Pharmacy
• Dental
• Vision
• Long Term Disability
• Health Savings Account
• Flexible Spending Account Options
• Life Insurance
• Accident Insurance
• Critical Illness Insurance
• Pre-paid Legal Insurance
• Parking and Transit FSA accounts
• 401K
• ROTH 401K
• Paid time off