Manager, Grievance and Appeals
Microsoft 365
Senior Regulatory Compliance Specialist
Spring Health
full-time
Posted on:
Origin: • 🇺🇸 United States
Visit company websiteSalary
💰 $129,000 - $159,350 per year
Job Level
Senior
About the role
- Manage all regulatory filings, license renewals, and required reports for the Department of Managed Healthcare (DMHC) and across multiple jurisdictions
- Maintain a comprehensive regulatory reporting calendar and ensure timely, accurate submissions
- Act as the primary liaison to regulatory bodies
- Develop and manage the regulatory exam and inquiry response process, partnering with legal and operational leaders as needed
- Lead regulatory change management efforts by translating legal regulatory summaries into actionable internal change plans
- Oversee internal policy development related to market conduct, regulatory obligations, and compliance controls
- Support internal audits and compliance reviews and guide cross-functional teams in remediation and process improvements
- Manage day-to-day activities of the Corporate Compliance and Ethics Program and oversee the corporate compliance regulatory function end-to-end
- Other Corporate Compliance duties as assigned
Requirements
- 5+ years of experience in a managed care environment managing regulatory filings, exams or audits
- Direct experience working with the California Department of Managed Health Care (DMHC)
- Prior healthcare compliance and auditing experience
- Strong understanding of federal and state regulatory frameworks (NAIC, CMS, HIPAA, ERISA, etc.)
- Proven ability to monitor, interpret, and implement new and revised regulations across multiple states
- Excellent communication and project management skills
- Bachelor's degree required; advanced degree or certification (e.g., CHC, CCEP, or CIRM) preferred
- Self-directed, resourceful, and proactive in raising concerns or ideas
