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CareCentrix · 3 hours ago

Analyst IV – Regulatory Compliance – Workers Compensation, Auto & Commercial

United States

Full-time

Remote

Senior Level

$100K/yr - $120K/yr

7+ years exp

CareCentrix is focused on regulatory compliance in the healthcare sector, and they are seeking an Analyst IV to monitor and ensure compliance with federal and state laws impacting their workers compensation, auto, and commercial programs. The role involves supporting legal requirements, continuous improvement efforts, and providing training and guidance within the Compliance Department.

Health CareHome Health CareWellness

No H1B

U.S. Citizen Only

Responsibilities

Monitor and track federal and state laws and guidance impacting CareCentrix's workers’ compensation, auto, and commercial program operations, analyze the information, and prepare and circulate written and verbal communications to affected business areas regarding such laws

Provide cross functional support, guidance, and direction in the development of policies, procedures, and other operational changes necessary to comply with legal requirements and support the operational areas in the implementation of such policies, procedures, and other changes as required

Secure and maintain required operational licenses

Assist in the implementation of new CareCentrix workers’ compensation, auto and commercial program customers

Identify continuous improvement efforts to ensure effective compliance tracking, trending, and reporting tools

Perform internal audits as needed and identify opportunities for improvement

Develop and deliver training programs to ensure a clear understanding of compliance requirements

Train and serve as mentor to new and other junior Compliance Department regulatory team members

Qualification

Regulatory compliance expertiseLegal backgroundAdvanced legal researchMS Office SuiteAnalytical abilitiesWritten communicationVerbal communicationOrganizational skillsAttention to detailStrategic thinkingCollaboration

Required

Bachelor's degree preferred; or a minimum of 7 years of experience in a managed care setting working with laws impacting workers' compensation, auto, and/or commercial health insurers and delegated entities

Expertise in regulations related to utilization management, claims, network management, and credentialing

Demonstrated experience in regulatory affairs and/or operations of HMOs, managed care organizations, and other insurers

Proficiency in MS Office Suite (Excel, SharePoint, PowerPoint, OneNote)

Advanced legal research skills, strong organizational and analytical abilities, excellent written and verbal communication and presentation skills, and attention to detail

In-depth knowledge of state and federal guidelines and regulations governing workers' compensation, auto, and/or commercial managed health care

Travel: up to 10% as needed