Regulatory Compliance Analyst

Job Summary

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.

Key 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.

Qualifications and Requirements

• Bachelor’s degree in healthcare administration, public health or related field.
• Certification in healthcare compliance (CHC) preferred.
• Minimum of four (4) years of managed care, healthcare operations, or regulatory compliance.
• 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.

Geographic Responsibility

Remote, US

Type of Employment

Full-time, permanent

FLSA Classification (USA Only)

Exempt

Work Environment

• The physical demands described here are representative of those that must be met by an employee to successfully perform the essential functions of this job:
• The employee is occasionally required to move around the office.
• Specific vision abilities required by this job include close vision, color vision, peripheral vision, depth perception, and ability to adjust focus.
• Work across multiple time zones in a hybrid or remote work environment.
• Long periods of time sitting and/or standing in front of a computer using video technology.
• May require travel dependent on company needs.

Annual US Base Salary Range

$75,000 to $95,000