[Remote] Analyst IV – Regulatory Compliance – Workers Compensation, Auto & Commercial

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Note: The job is a remote job and is open to candidates in USA. CareCentrix is focused on regulatory compliance in the healthcare sector, and they are seeking an Analyst IV to monitor and ensure compliance with federal and state laws impacting their workers compensation, auto, and commercial programs. The role involves supporting legal requirements, continuous improvement efforts, and providing training and guidance within the Compliance Department.


Responsibilities

  • 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

Skills

  • 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
  • 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
  • Legal Background: JD or paralegal experience preferred

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
  • And more.

Company Overview

  • CareCentrix is a home health center that offers post-acute care, home infusion, and serious illness care services. It was founded in 1996, and is headquartered in Hartford, Connecticut, USA, with a workforce of 1001-5000 employees. Its website is http://www.carecentrix.com.

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