Regulatory Compliance Associate

NJM Insurance Group

Regulatory Compliance Associate responsible for ensuring compliance with healthcare regulations and guidelines. Collaborating with internal divisions and overseeing compliance reporting for Horizon's health plan operations.

Posted 4/24/2026full-timeNewark • New Jersey • 🇺🇸 United StatesJuniorMid-Level💰 $87,300 - $119,070 per yearWebsite

About the role

Key responsibilities & impact

Responsible for the identification and communication of new, revised, and pending federal and state laws, regulations, and standards relevant to a Horizon Lines of Business (LOB)
Administers and coordinates the functions associated with compliance and regulatory guidelines related to each market
Develop and maintain standard operating policies and procedures, compliance reporting and dashboards
Support and actively participate in annual team functions including monitoring, ongoing risk assessment, audit readiness activities, and external audit coordination
Independently investigate areas of non-compliance and design and coordinate internal investigations and resulting corrective action plans
Gather relevant data and Key Performance Indicators for compliance reports and dashboards, and prepare reports based on established reporting metrics

Requirements

What you’ll need

High School Diploma/GED required
Bachelor degree preferred or relevant experience in lieu of degree
Minimum of five (5) years of relevant compliance experience in a healthcare or managed care environment
Minimum of three (3) years experience in the interpretation and application of federal and state regulations, policies and procedures, and ethical principles related to healthcare compliance
Knowledge of the sources of legal and regulatory requirements relevant to state and federal requirements
Knowledge of the Federal and State regulatory environment in the health insurance industry, with emphasis on Medicaid and NJFamilyCare, Managed Long-Term Services and Supports, the New Jersey False Claims Act, Fraud, Waste and Abuse, Anti-Kickback law and State Medicaid requirements
Knowledge of state and federal laws and regulations, including CMS, DOBI and DMAHS requirements.
Excellent at organizing, managing, and handling competing projects with a proven ability to meet tight deadlines in a fast-paced environment.

Benefits

Comp & perks

Comprehensive health benefits (Medical/Dental/Vision)
Retirement Plans
Generous PTO
Incentive Plans
Wellness Programs
Paid Volunteer Time Off
Tuition Reimbursement

ATS Keywords

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Applicant Tracking System Keywords

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Hard Skills & Tools

compliance reportingrisk assessmentaudit coordinationinvestigation of non-compliancecorrective action plansKey Performance Indicatorsstandard operating proceduresdata analysisregulatory guidelineshealthcare compliance

Soft Skills

communicationorganizationproject managementtime managementproblem-solvingattention to detailindependenceteam collaborationadaptabilityability to meet deadlines

Certifications

High School DiplomaGEDBachelor's degree (preferred)