Government Programs Regulatory Reporting Lead - Health Plan

Sanford Health; Iowa (LA); Remote; USD 60,000 - 80,000; Full time

Job summary

An established industry player is seeking a Government Programs Regulatory Reporting Lead to ensure compliance with State and Federal regulations. This role involves managing reporting and auditing processes for Medicare Advantage and Medicaid, collaborating with operational units to maintain accurate product definitions and member communications. The ideal candidate will have a strong background in healthcare, regulatory reporting, and audit readiness. Join a forward-thinking organization that values work/life balance and offers a comprehensive benefits package, including health, dental, and generous paid time off.

Benefits

Health Insurance

Dental Insurance

Vision Insurance

401(k) Plan

Generous Paid Time Off

Work/Life Balance Benefits

Qualifications

• 5+ years of experience in healthcare reimbursement or contract negotiations.
• Expertise in regulatory reporting and compliance standards.

Responsibilities

• Ensure compliance with State and Federal regulations for Government Programs.
• Manage reporting, auditing, and data exchange for Medicare Advantage and Medicaid.

Skills

Regulatory Reporting

Audit Readiness

Healthcare Compliance

Data Management

Education

Bachelor's Degree in Healthcare

Bachelor's Degree in Finance

Bachelor's Degree in Related Field

Job description

Government Programs Regulatory Reporting Lead - Health Plan | Sanford Careers

Sanford Health

Government Programs Regulatory Reporting Lead - Health Plan Remote, Iowa

Location: Remote, IA

Shift: Varies

Job Schedule: Full-time

Weekly Hours: 40

Salary Range: $32.50 - $52.00

This position can be remote or in-office. If remote, some in-person attendance will be required for training, team meetings, or special projects, scheduled in advance.

Job Summary

The Government Programs Regulatory Reporting Lead will serve as the subject matter expert for regulated reporting and audit readiness of the Government Program products, including Medicare Advantage, ACA, and Medicaid. Responsibilities include ensuring compliance with all State and Federal regulations and deadlines, assisting with data submissions, internal validations, and other tasks. The role manages reporting, auditing, and data exchange for these programs, collaborating with operational units to ensure accurate product definitions, member communications, and timely data exchanges that meet regulatory standards. The position also involves serving as the main contact for reporting questions, leading development and process improvements, and ensuring compliance with certifications, quality reporting, and regulatory standards. Occasional travel is required.

Qualifications

• Bachelor's degree in healthcare, finance, or a related field
• Minimum five years of relevant experience
• Experience in healthcare reimbursement or contract negotiations preferred

Sanford Health offers a comprehensive benefits package, including health, dental, vision, life insurance, a 401(k), work/life balance benefits, and generous paid time off. For more information, visit https://sanfordcareers.com/benefits.

Sanford is an EEO/AA employer. Applicants with disabilities may request accommodations by calling 1-877-673-0854 or emailing [e-mail].

Sanford Health enforces a Drug-Free Workplace Policy. Employment is contingent upon passing a drug screen and background check.