Network Regulatory & Compliance Specialist

MCS Puerto Rico

San Juan (PR)

On-site

USD 70,000 - 100,000

Full time

11 hours ago

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Job summary

MCS Puerto Rico seeks a Regulatory Compliance professional to support audit readiness, risk assessments, and action plan management within Network Management. You will work with cross-functional teams to monitor KPIs, contracts, credentialing, and regulatory reviews to ensure adherence to federal, state, accreditation, and contractual requirements.

The role emphasizes collaboration, documentation maintenance, and continuous improvement to strengthen compliance and mitigate risk across NM

Qualifications

Bachelor’s degree in Health Services Administration, Public Health, or related field.
At least 2 years of healthcare regulatory compliance or related experience.
Experience with audits, risk assessments, and corrective actions.

Responsibilities

Serve as the primary liaison between NM and Compliance to coordinate regulatory requirements.
Evaluate regulatory changes affecting provider network operations and coordinate readiness activities.
Identify and monitor operational and regulatory risks within NM activities and recommend mitigations.
Prepare and present risk assessments, readiness status updates, corrective action progress to NM leadership.
Coordinate and support audit readiness initiatives by maintaining documentation and evidence repositories.
Develop dashboards, KPIs, and metrics to identify trends and support compliance decisions.
Must comply with all company policies and applicable laws.