Analyst IV – Regulatory Compliance, Workers Compensation, Auto & Commercial
CareCentrix
full-time
Posted on:
Location Type: Remote
Location: United States
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Salary
💰 $100,000 - $120,000 per year
About the role
- 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.
Requirements
- 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.
- Legal Background: JD or paralegal experience preferred.
- 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.
- Sponsorship is not available for this role (e.g., H-1B, F-1, OPT, CPT).
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
- corporate bonus incentive
Applicant Tracking System Keywords
Tip: use these terms in your resume and cover letter to boost ATS matches.
Hard Skills & Tools
regulatory affairsutilization managementclaims managementnetwork managementcredentialinglegal researchcompliance trackinginternal auditspolicy developmenttraining program development
Soft Skills
organizational abilitiesanalytical abilitieswritten communicationverbal communicationpresentation skillsattention to detailmentoring
Certifications
Bachelor's degreeJDparalegal experience