Regulatory Compliance Analyst IV – Workers Compensation

Overview: Responsible for monitoring federal and state regulatory requirements impacting CareCentrix workers compensation, auto, and commercial programs operations and for supporting the compliant implementation of legal and customer requirements. Identifies and facilitates continuous improvement efforts to ensure compliance with applicable legal requirements. Secure and maintain required operational licenses. 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.

Other Job Specific Competencies:

• Ownership and Autonomous Decision-Making -Demonstrates strong ownership and accountability; operates with a high degree of autonomy and consistently exercises sound judgment in decision-making.
• Strategic Thinking: Able to anticipate future trends, align initiatives with long-term organizational objectives, and translate vision into actionable plans.
• Influence and Collaboration: Builds strong relationships across functions, persuades stakeholders effectively, and fosters a culture of teamwork.

Qualifications:

• 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). All candidates must reside in the United States to be considered. What We Offer:

• Pay Range: $100000 - $120000 plus corporate bonus incentive.
• 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.
• Award winning culture: Keeps our company values at the heart of everything we do: We Care; We Do the Right Thing; We Strive for Excellence; We Think BIG; We Take our Work Seriously, Not Ourselves.

#IDCC CareCentrix maintains a drug-free workplace. We are an equal opportunity employer. Employment selection and related decisions are made without regard to age, race, color, national origin, religion, sex, disability, sexual orientation, gender identification, or being a qualified disabled veteran or qualified veteran of the Vietnam era or any other category protected by Federal or State law. CareCentrix accepts applications on an ongoing basis until a candidate is identified. Apply tot his job Apply To this Job