Director-Regulatory Compliance

Medrisk Llc; Conshohocken (Montgomery County); On-site; USD 140,000 - 160,000; Full time

Job summary

Medrisk Llc in Conshohocken, PA is seeking a Director-Regulatory Compliance to lead the regulatory program for workers’ compensation, managed care, and medical billing operations.

You will monitor legislative changes, manage state filings, and serve as liaison with regulators, customers, and internal teams to ensure program compliance.

The role oversees a team responsible for platform compliance, training, and URAC certification support.

Qualifications

• Regulatory research and interpretation for state and federal changes.
• Project management in regulated environments with cross-functional teams.
• Strong communication skills, both written and oral.

Responsibilities

• Monitor and analyze state/federal regulatory developments, legislation, and industry trends affecting workers’ compensation.
• Research, track, and assess regulatory impacts on managed care, bill review, and timely pay operations.
• Communicate regulatory changes to internal teams and customers.
• Develop compliance training materials with subject‑matter expertise.
• Support URAC certification and reaccreditation for clinical operations.

Skills

Regulatory research

Project management

Communication

Attention to detail

Problem-solving

Self-starter mindset

Education

Bachelor’s degree in business administration or related field

Job description

If you are unable to complete this application due to a disability, contact this employer to ask for an accommodation or an alternative application process.

Director-Regulatory Compliance

IT Product Planning Management Conshohocken, PA, US

Salary Range: $140,000.00 To $160,000.00 Annually

Role Overview

This position supports MedRisk's Payment Integrity compliance program, acting as a regulatory subject‑matter expert for workers’ compensation, managed care, and medical billing operations. The role involves monitoring legislative and regulatory changes, managing state filings, and serving as the primary liaison with regulatory agencies, customers, and internal teams. The role manages a comprehensive team responsible for platform compliance.

Key Responsibilities

Regulatory & Compliance

• Monitor and analyze state/federal regulatory developments, legislation, and industry trends affecting workers’ compensation.
• Research, track, and assess regulatory impacts on managed care, bill review, and timely pay operations.
• Communicate regulatory changes to internal teams and customers.
• Develop compliance training materials with subject‑matter expertise.
• Support URAC certification and reaccreditation for clinical operations.

Managed Care & Filing

• Manage certified managed care programs (MPN/MCO) including state filings, renewals, amendments, and reporting.
• Manage state regulatory agencies on filings, audits, deficiencies, and inquiries.
• Maintain historical archives and resource documentation for state filings.

Team & Operations

• Coordinate resources to ensure ongoing effectiveness of state managed care programs.
• Support cross‑functional projects and compliance documentation.

Requirements

• Education: Bachelor’s degree in business administration or related field.
• Experience: 10+ years in business or industry, with significant experience in workers’ compensation state managed care and medical bill review.
• Skills: Regulatory research and interpretation, project management in regulated environments, communication (oral/written), attention to detail, problem‑solving, and self‑starter mindset