Healthcare Regulatory Compliance Analyst - Workers Comp and Commercial Programs
Overview:
Responsible for monitoring federal and state regulatory requirements impacting CareCentrix workers compensation, auto, and commercial programs operations and for supporting the compliant implementation of legal and customer requirements. Identifies and facilitates continuous improvement efforts to ensure compliance with applicable legal requirements. Secure and maintain required operational licenses.
Responsibilities:
• Monitor and analyze federal and state laws and guidance affecting CareCentrix’s workers’ compensation, auto, and commercial program operations. Prepare and distribute clear written and verbal communications to impacted business areas.
• Provide cross‑functional support, guidance, and direction in developing policies, procedures, and operational changes required for legal and regulatory compliance. Partner with operational teams to implement these changes effectively.
• Secure and maintain all required operational licenses.
• Support the onboarding and implementation of new CareCentrix workers’ compensation, auto, and commercial program clients.
• Identify and drive continuous improvement initiatives to enhance compliance tracking, trending, and reporting capabilities.
• Conduct internal audits as needed and identify opportunities for process improvement.
• Develop and deliver training programs to ensure teams fully understand compliance requirements.
Job‑Specific Competencies:
• Demonstrates strong accountability and operates with a high level of independence, consistently applying sound judgment in decision-making.
• Anticipates future trends, aligns initiatives with long‑term organizational goals, and translates strategic vision into actionable plans.
• Builds effective cross‑functional relationships, persuasively engages stakeholders, and promotes a collaborative, team‑oriented culture.
Qualifications:
• Bachelor’s degree preferred, or a minimum of 5 years of experience in a managed care setting working with laws impacting workers’ compensation, auto, and/or commercial health insurers and delegated entities. This includes experience with regulations governing utilization management, claims, network management, and credentialing.
• Demonstrated experience in regulatory affairs and/or the operations of HMOs, managed care organizations, or other insurers.
• Proficiency in Microsoft Office applications, including Excel, SharePoint, PowerPoint, and OneNote.
• Advanced legal research abilities; strong organizational and analytical skills; excellent written, verbal, and presentation communication skills; and exceptional attention to detail.
• Requires in‑depth knowledge of state and federal workers’ compensation, auto, and/or commercial managed healthcare regulations and guidelines.
What We Offer:
• Pay Range: $80000 - $95000 per year plus corporate bonus incentive.
• Benefits: Medical, Dental, Vision, 401(k) with company match, HSA employer contributions, Dependent Care FSA employer contribution, Paid Time Off, Personal/Sick Time, Paid Parental Leave, and more.
• Award winning culture: Keeps our company values at the heart of everything we do: We Care; We Do the Right Thing; We Strive for Excellence; We Think BIG; We Take our Work Seriously, Not Ourselves.
#IDCC
CareCentrix maintains a drug-free workplace.
We are an equal opportunity employer. Employment selection and related decisions are made without regard to age, race, color, national origin, religion, sex, disability, sexual orientation, gender identification, or being a qualified disabled veteran or qualified veteran of the Vietnam era or any other category protected by Federal or State law.
CareCentrix accepts applications on an ongoing basis until a candidate is identified.
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Responsible for monitoring federal and state regulatory requirements impacting CareCentrix workers compensation, auto, and commercial programs operations and for supporting the compliant implementation of legal and customer requirements. Identifies and facilitates continuous improvement efforts to ensure compliance with applicable legal requirements. Secure and maintain required operational licenses.
Responsibilities:
• Monitor and analyze federal and state laws and guidance affecting CareCentrix’s workers’ compensation, auto, and commercial program operations. Prepare and distribute clear written and verbal communications to impacted business areas.
• Provide cross‑functional support, guidance, and direction in developing policies, procedures, and operational changes required for legal and regulatory compliance. Partner with operational teams to implement these changes effectively.
• Secure and maintain all required operational licenses.
• Support the onboarding and implementation of new CareCentrix workers’ compensation, auto, and commercial program clients.
• Identify and drive continuous improvement initiatives to enhance compliance tracking, trending, and reporting capabilities.
• Conduct internal audits as needed and identify opportunities for process improvement.
• Develop and deliver training programs to ensure teams fully understand compliance requirements.
Job‑Specific Competencies:
• Demonstrates strong accountability and operates with a high level of independence, consistently applying sound judgment in decision-making.
• Anticipates future trends, aligns initiatives with long‑term organizational goals, and translates strategic vision into actionable plans.
• Builds effective cross‑functional relationships, persuasively engages stakeholders, and promotes a collaborative, team‑oriented culture.
Qualifications:
• Bachelor’s degree preferred, or a minimum of 5 years of experience in a managed care setting working with laws impacting workers’ compensation, auto, and/or commercial health insurers and delegated entities. This includes experience with regulations governing utilization management, claims, network management, and credentialing.
• Demonstrated experience in regulatory affairs and/or the operations of HMOs, managed care organizations, or other insurers.
• Proficiency in Microsoft Office applications, including Excel, SharePoint, PowerPoint, and OneNote.
• Advanced legal research abilities; strong organizational and analytical skills; excellent written, verbal, and presentation communication skills; and exceptional attention to detail.
• Requires in‑depth knowledge of state and federal workers’ compensation, auto, and/or commercial managed healthcare regulations and guidelines.
What We Offer:
• Pay Range: $80000 - $95000 per year plus corporate bonus incentive.
• Benefits: Medical, Dental, Vision, 401(k) with company match, HSA employer contributions, Dependent Care FSA employer contribution, Paid Time Off, Personal/Sick Time, Paid Parental Leave, and more.
• Award winning culture: Keeps our company values at the heart of everything we do: We Care; We Do the Right Thing; We Strive for Excellence; We Think BIG; We Take our Work Seriously, Not Ourselves.
#IDCC
CareCentrix maintains a drug-free workplace.
We are an equal opportunity employer. Employment selection and related decisions are made without regard to age, race, color, national origin, religion, sex, disability, sexual orientation, gender identification, or being a qualified disabled veteran or qualified veteran of the Vietnam era or any other category protected by Federal or State law.
CareCentrix accepts applications on an ongoing basis until a candidate is identified.
Apply tot his job
Apply To this Job