This role is responsible for advancing compliance across a regulated healthcare organization through effective management of hotline inquiries, incident response, and conflict of interest processes. The analyst ensures adherence to federal regulations including Medicare, Medicaid, and the Affordable Care Act, while supporting governance through accurate reporting and policy enforcement.
Key Responsibilities
- Manage end-to-end compliance investigations, ensuring timely resolution and documentation of incidents.
- Lead high-visibility initiatives involving sensitive compliance matters, coordinating with cross-functional teams and external stakeholders.
- Prepare and deliver executive-level reports for senior leadership, the Compliance Committee, and Board of Directors by gathering and synthesizing data across departments.
- Interpret evolving regulatory requirements and industry standards, applying them to internal policies and operational practices.
- Develop and refine compliance frameworks, leveraging precedent and organizational knowledge to resolve complex issues.
- Support compliance data analysis using Power BI and other Microsoft 365 tools to assess program effectiveness and identify risk areas.
- Collaborate with legal, governance, and operational teams to ensure alignment across contracts, projects, and regulatory expectations.
Qualifications
A bachelor’s degree in business, healthcare, or a related field is required, along with at least five years of experience in legal or compliance roles within healthcare, pharmacy benefit management, or similarly regulated sectors. Candidates must have direct experience managing compliance investigations, conflict of interest disclosures, and regulatory reporting.
Proficiency with Microsoft SharePoint, Teams, Forms, Lists, and Power BI is essential. Strong analytical, communication, and project management abilities are required to navigate complex compliance challenges and influence decision-making at all levels.
Preferred candidates hold certifications such as CCEP, CHC, or PMP, or possess an advanced degree such as a Juris Doctor. A demonstrated understanding of compliance program fundamentals and the ability to present nuanced information clearly to diverse audiences are critical to success.
Work Environment
This is a remote position with up to 10% travel. The organization supports a purpose-driven, inclusive culture committed to equal opportunity and legal compliance. All qualified applicants, including those with arrest or conviction records, are encouraged to apply and will be considered with appropriate accommodations.
