Compliance Specialist

University-Health-3; San Antonio (TX); On-site; USD 70,000 - 110,000; Full time

Job summary

University-Health-3 is seeking a Compliance & Regulatory Specialist to assist in overseeing compliance across the health plan’s operations and regulatory reporting. The role focuses on ensuring adherence to Texas Medicaid regulations, TDI requirements, and CMS guidelines.

This position will help coordinate regulatory deliverables and interpret rule changes with HIPAA considerations. The candidate will build and nurture relationships with regulators and internal teams to drive transparency,

Qualifications

• Bachelor's degree or equivalent experience in healthcare/administration or related field.
• Proficiency in Microsoft Office applications.

Responsibilities

• Assist in oversight and execution of compliance in health plan operations and regulatory reporting.
• Coordinate regulatory deliverables and interpret changes in regulations and guidelines, including HIPAA.
• Build relationships with regulatory agencies and internal stakeholders to improve transparency and accountability.

Skills

Regulatory compliance

Regulatory reporting

Stakeholder relationship management

Education

Bachelor's degree in business administration, public administration, health care administration or related field

Tools

Microsoft Office

Job description

POSITION SUMMARY/RESPONSIBILITIES

The Compliance & Regulatory Specialist is responsible for assisting in the oversight and execution of compliance in the health plan’s operational areas, including delegated operational activities and regulatory reporting. The candidate must be familiar with current Texas Medicaid regulations, the Texas Department of Health and Human Services, Texas Department of Insurance (TDI) regulations, the Office of Inspector General (OIG) Compliance Plan, the Centers for Medicare and Medicaid Services (CMS) and should also be familiar with health plan documents such as Summaries of Benefits and Coverage, Schedules of Benefits and Certificates of Coverage. This position will coordinate and facilitate the execution of the company’s regulatory deliverables. The Compliance & Regulatory Specialist will assist with the interpretation of and/or execution of changes in regulations and guidelines, including HIPAA. This position will need to build key relationships with regulatory agencies and internally to facilitate improved interaction, transparency and accountability.

EDUCATION/EXPERIENCE

A bachelor's degree in business administration, public administration, health care administration or a related field is desired but will accept experience in lieu of education. Proficiency in Microsoft Office applications.