Senior Regulatory Compliance Consultant

Avesis

22d • Remote

About The Position

Join us for an exciting career with the leading provider of supplemental benefits! Our Promise Through skill-building, leadership development and philanthropic opportunities, we provide opportunities to build communities and grow your career, surrounded by diverse colleagues with high ethical standards. The Senior Regulatory Compliance Consultant will develop analysis and regulatory interpretation of state and federal laws and regulations impacting Avēsis programs and products. This role will coordinate and lead, implementation activities critical to ensuring Avēsis exceeds expectations, outcomes and requirements associated with state or federal regulatory guidance, rules, requests, inquiries, and actions. This role will interface with leaders and operational teams to provide applicable regulatory guidance and expertise. Our chosen candidate will have deep knowledge of government Managed Care programs with demonstrated ability to identify, analyze and translate laws, regulations, guidance, and contract requirements applicable to Avesis LLC businesses; effectively communicate how the related business/functional processes and departments are impacted and validate the implementation of the necessary changes made by those impacted. We’re seeking a self-motivated, critical thinker with excellent analytical skills who can translate regulations into clear tactical guidance for business and functional partners and demonstrates a bias for action. This is a telecommuter position. Competencies: Functional: Monitor, track and keep abreast of all applicable laws, regulations, and guidelines that pertain to the company. Perform regulatory interpretation and analysis of new laws and regulations to develop written communications to advise the business on implementation of changes to comply. Work with business owners to validate policies, procedures, and processes are developed, designed and implemented in accordance with relevant laws, regulations, and guidelines. Identify and evaluate potential risks to the company including developing, communicating, and executing initiatives to promote awareness and understanding of compliance issues, applicable laws and regulations, requirements, and consequences on non-compliance. Provide regulatory interpretive guidance in support of company initiatives and programs. Interface with external clients and regulatory bodies to address inquiries, and support audit or examination activities. Proactively identify, address, and resolve compliance issues in partnership with business stakeholders. Core: Proficiency with conducting regulatory research to interpret, analyze, and articulate the impact of legislation, regulatory and contractual requirements to business processes and policies. Excellent interpersonal skills and demonstrated proficiency in written and verbal communication with internal partners and external state or federal regulators. Strong analytical, decision-making, planning and people/project management skills to manage shifting priorities Ability to perform critical thinking and develop innovative solutions to issues or problems related to compliance. Ability to interact and collaborate with all members of the organization in ways that enhance understanding, respect, cooperation, and problem solving. Ability to work independently and with minimal direction. Demonstrated project management skills. Behavioral: Collegiality: building strong relationships on company-wide, approachable, and helpful, ability to mentor and support team growth. Initiative: readiness to lead or take action to achieve goals. Communicative: ability to relay issues, concepts, and ideas to others easily orally and in writing. Member-focused: going above and beyond to make our members feel seen, valued, and appreciated. Detail-oriented and thorough: managing and completing details of assignments without too much oversight. Flexible and responsive: managing new demands, changes, and situations. Critical Thinking: effectively troubleshoot complex issues, problem solve and multi-task. Integrity & responsibility: acting with a clear sense of ownership for actions, decisions and to keep information confidential when required. Collaborative: ability to represent your own interests while being fair to those representing other or competing ideas in search of a workable solution for all parties.

Requirements

• Bachelor’s degree in business, healthcare, or related area of study, or equivalent education and work experience
• 5+ years of experience in compliance, privacy and/or regulatory affairs in regulatory analysis and interpretation role; preferably a government, health care or managed care environment.
• Intermediate experience with legal research applications (e.g. Lexis, Westlaw).
• Experience with handling state regulatory and/or product filings on a multi-state level.
• As this role is a remote role, you are required to maintain internet service that allows you to complete your essential job duties without issue. Rates of 50 Mbps download and 10 Mbps upload while hardwired and not on a VPN are sufficient.
• 2+ years’ experience working with Medicare and Medicaid laws/regulations.
• Working knowledge of managed care and dental/vision benefit plans.

Responsibilities

• Monitor, track and keep abreast of all applicable laws, regulations, and guidelines that pertain to the company.
• Perform regulatory interpretation and analysis of new laws and regulations to develop written communications to advise the business on implementation of changes to comply.
• Work with business owners to validate policies, procedures, and processes are developed, designed and implemented in accordance with relevant laws, regulations, and guidelines.
• Identify and evaluate potential risks to the company including developing, communicating, and executing initiatives to promote awareness and understanding of compliance issues, applicable laws and regulations, requirements, and consequences on non-compliance.
• Provide regulatory interpretive guidance in support of company initiatives and programs.
• Interface with external clients and regulatory bodies to address inquiries, and support audit or examination activities.
• Proactively identify, address, and resolve compliance issues in partnership with business stakeholders.

Benefits

• Excellent medical, dental, supplemental health, life and vision coverage for you and your dependents with no wait period.
• Life and disability insurance.
• A great 401(k) with company match.
• Tuition assistance, paid parental leave and backup family care.
• Dynamic, modern work environments that promote collaboration and creativity to develop and empower talent.
• Flexible time off, dress code, and work location policies to balance your work and life in the ways that suit you best.
• Employee Resource Groups that advocate for inclusion and diversity in all that we do.

What This Job Offers

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