Empowering Health at Home

Regulatory Compliance Analyst III – Workers Comp, Commercial Programs

ComplianceComplianceFull TimeRemoteTeam 1,001-5,000Since 1996H1B SponsorCompany Site LinkedIn

Location

United States

Posted

14 days ago

Salary

$80K - $95K / year

Bachelor Degree5 yrs expExperience acceptedEnglish

Job Description

• Monitor and analyze federal and state laws and guidance affecting CareCentrix’s workers’ compensation, auto, and commercial program operations. • Prepare and distribute clear written and verbal communications to impacted business areas. • Provide cross‑functional support, guidance, and direction in developing policies, procedures, and operational changes required for legal and regulatory compliance. • Partner with operational teams to implement these changes effectively. • Secure and maintain all required operational licenses. • Support the onboarding and implementation of new CareCentrix workers’ compensation, auto, and commercial program clients. • Identify and drive continuous improvement initiatives to enhance compliance tracking, trending, and reporting capabilities. • Conduct internal audits as needed and identify opportunities for process improvement. • Develop and deliver training programs to ensure teams fully understand compliance requirements.

Job Requirements

Bachelor’s degree preferred, or a minimum of 5 years of experience in a managed care setting working with laws impacting workers’ compensation, auto, and/or commercial health insurers and delegated entities.
This includes experience with regulations governing utilization management, claims, network management, and credentialing.
Demonstrated experience in regulatory affairs and/or the operations of HMOs, managed care organizations, or other insurers.
Proficiency in Microsoft Office applications, including Excel, SharePoint, PowerPoint, and OneNote.
Advanced legal research abilities; strong organizational and analytical skills; excellent written, verbal, and presentation communication skills; and exceptional attention to detail.
Requires in-depth knowledge of state and federal workers’ compensation, auto, and/or commercial managed healthcare regulations and guidelines.