Government Programs Regulatory Reporting Lead - Health Plan

Sanford Health; South Dakota; Remote; Full time

Job summary

Sanford Health is seeking a Government Programs Regulatory Reporting Lead to ensure compliance with regulations for Medicare Advantage, ACA, and Medicaid. This full-time remote role involves managing audits, reporting, and collaborating across operational units. The ideal candidate will have a Bachelor's degree and at least five years of relevant experience in healthcare reimbursement or contract negotiation.

Benefits

Health Insurance

Dental Insurance

Vision Insurance

Life Insurance

401(k)

Generous Time Off

Qualifications

• Minimum five years of relevant experience.

Responsibilities

• Ensure compliance with all State and Federal regulations.
• Manage reporting, auditing, and data exchange.
• Lead process improvements and education initiatives.

Skills

Healthcare Reimbursement

Contract Negotiation

Education

Bachelor's degree in healthcare

Bachelor's degree in finance

Job description

Government Programs Regulatory Reporting Lead - Health Plan

Join to apply for the Government Programs Regulatory Reporting Lead - Health Plan role at Sanford Health.

Sanford Health is one of the largest and fastest-growing not-for-profit health systems in the United States. We offer many development and advancement opportunities to our nearly 50,000 members of the Sanford Family, dedicated to health and healing across our broad footprint.

Facility: Remote SD (Central Time)

Location: Remote, SD

Shift: Varies

Job Schedule: Full-time

Weekly Hours: 40.00

Salary Range: $32.50 - $52.00

Department Details: This position can be remote or in-office. If remote, some in-person attendance may 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 timelines, managing reporting, auditing, and data exchange, collaborating with operational units, and leading process improvements and education initiatives. The role also involves ensuring certifications, quality reporting, member materials, website content, and regulatory standards are met. Occasional travel is required.

Qualifications

• Bachelor's degree in healthcare, finance, or related field.
• Minimum five years of relevant experience; healthcare reimbursement or contract negotiation experience preferred.

Benefits

Sanford Health offers an attractive benefits package, including health, dental, vision, life insurance, a 401(k), work/life balance benefits, and generous time off. For more details, visit our benefits page.

Sanford is an EEO/AA Employer. Accommodations are available for applicants with disabilities. Drug screening and background checks are required.

Req Number: R-0220555

Job Function: Health Plan

Industries: Hospitals and Healthcare