Regulatory Compliance Officer at Insight Global
Philadelphia, PA 19103, USA -
Full Time


Start Date

Immediate

Expiry Date

14 Nov, 25

Salary

43.3

Posted On

14 Aug, 25

Experience

0 year(s) or above

Remote Job

Yes

Telecommute

Yes

Sponsor Visa

No

Skills

Good communication skills

Industry

Hospital/Health Care

Description

JOB DESCRIPTION:

As a Regulatory Compliance Analyst, you will identify, document, and track the resolution of compliance issues in operational performance areas (e.g. billing, enrollment, claims) of a major health insurance issuer. You will also research state and federal laws relating to the Affordable Care Act, providing key insights to guide our operations.
We are looking for a highly independent professional with a knack for research, analysis, and adaptive problem solving. A legal background is a significant plus for success in this position.

Responsibilities
  • Regulatory Analysis: Interpret and analyze federal and state regulatory requirements, providing clear regulatory guidance to operational teams and ensuring effective implementation of new laws and regulations.
  • Corrective Action Plan (CAP) Tracking: Leverage compliance tracking software to document CAPs and develop remediation plans, ensuring alignment with regulatory standards. Maintain regular updates on disclosed issues.
  • Operational Collaboration: Work closely with business areas to address compliance gaps, ensuring that they are taking appropriate ownership of any CAPs under their purview, thoroughly analyzing root cause, providing evidence remediation, and documenting updated processes in policies and procedures.
  • Proactive Monitoring: Analyze indicators, identify trends, and monitor potential compliance risks, escalating issues and driving resolution as needed.
    Qualifications:
    · Education & Experience: Bachelor’s degree or equivalent work experience, with a minimum of 3 years in managed care, health care, or related field.
    · Preferred Background: Experience in compliance and familiarity with health insurance operations and regulations (especially the Affordable Care Act). A JD or legal research experience are both highly advantageous.
    · Skills: Exceptional organizational, verbal, and written communication skills; proficiency in Microsoft Office (especially Outlook, Teams, Word, Excel); familiarity with Citrix; adaptability to new technology, and the ability to work independently in a fast-paced environment are all musts.
    Job Type: Contract
    Pay: Up to $43.30 per hour

Benefits:

  • 401(k)
  • Dental insurance
  • Health insurance
  • Paid time off
  • Vision insurance

Application Question(s):

  • Can you describe your approach to reviewing and analyzing large volumes of legal documents on a daily basis?

Ability to Commute:

  • Philadelphia, PA 19103 (Required)

Work Location: In perso

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