Senior Analyst, UM Regulatory Operations

About the role:

You will support the design, optimization, and implementation of processes and improvements to operations in support of achieving organizational goals. You will be responsible to support implementations for regulatory requirements, compliance initiatives, UM audits, and other projects, as needed. You will report into the Senior Manager, UM Regulatory Operations.

Responsibilities:

• Coordinate projects and processes to help support key regulatory and compliance milestones and deliverables
• Partner with leadership to implement regulations, support key state filings, and other projects
• Partner with cross-functional teams to ensure action plans and process improvements align with project goals, and participate in collaboration with peers and cross-functional stakeholders
• Support audit exams (NCQA, MHPAEA, State)
• Help identify risks; respond to and resolve compliance gaps through regulatory implementation and in response to audits and Corrective Action Plans
• Compliance with all applicable laws and regulations
• Other duties as assigned

Requirements:

• 1+ years of experience in healthcare audits, or accreditations supporting NCQA and/or regulatory compliance
• 1+ years of professional experience in utilization management, healthcare operations and/or compliance, or a related field
• 1+ years of experience in Adobe Acrobat, and Google Suite or Microsoft Office (Sheets/Excel, Docs/Word, Slides/Powerpoint, etc)
• 1+ years of experience with interdepartmental collaboration with stakeholders to drive projects

Bonus points:

• 1+ years of experience supporting state audits and exams
• ACA marketplace, utilization management, healthcare quality and compliance, or provider data experience
• Training or experience applying Continuous Process Improvement or Lean Six Sigma principles
• Experience with project coordination or management in a matrixed organization
• 1+ years of experience in developing and presenting information and recommendations