Regulatory Compliance Specialist

IntePros; Philadelphia (Philadelphia County); Presencial; USD 61.992 - 68.880; Jornada completa

Descripción de la vacante

A healthcare consulting firm in Philadelphia is seeking a Regulatory Compliance Analyst to support operational compliance across billing, enrollment, and claims for major health insurance. The candidate must have at least 3 years in managed care or healthcare operations, with strong communication skills and expertise in the Affordable Care Act being a major plus. This role offers competitive hourly pay and requires proficiency in Microsoft Office tools.

Formación

• Minimum 3 years in managed care, healthcare operations, or a related field.
• Strongly preferred: experience with regulatory compliance and ACA-related regulations.
• JD or legal research experience is highly desirable.

Responsabilidades

• Monitor and interpret state and federal regulations.
• Document compliance issues using tracking systems.
• Partner with operations teams to investigate noncompliance.

Conocimientos

Strong written and verbal communication skills

Proficiency in Microsoft Office

Familiarity with compliance tracking tools

Detail-oriented

Educación

Bachelor's degree or equivalent experience

Herramientas

Microsoft Office

Citrix

Descripción del empleo

Overview

Job Title: Regulatory Compliance Analyst

Location: Philadelphia, PA

We’re seeking a sharp, proactive Regulatory Compliance Analyst to join our client's team and support operational compliance across core functions like billing, enrollment, and claims for a major health insurance issuer. In this role, you’ll monitor regulatory developments, track compliance gaps, and collaborate with operational teams to implement corrective actions. A strong legal or research background—particularly related to the Affordable Care Act—is a major plus.

Base pay range: $45.00/hr - $50.00/hr

What You’ll Do

• Regulatory Research & Analysis: Monitor and interpret state and federal regulations, translating requirements into actionable guidance for internal teams.
• Compliance Tracking & CAP Management: Document compliance issues using tracking systems, develop and monitor Corrective Action Plans (CAPs), and ensure issues are resolved effectively and on time.
• Cross-Functional Collaboration: Partner with operations teams to investigate root causes of noncompliance, implement remediations, and update policies and procedures accordingly.
• Risk Monitoring: Analyze trends, flag potential compliance risks, and support resolution to maintain adherence to regulatory standards.

Education & Experience

• Bachelor's degree or equivalent experience
• Minimum 3 years in managed care, healthcare operations, or a related field
• Strongly preferred: experience with regulatory compliance and ACA-related regulations
• JD or legal research experience is highly desirable

Skills & Tools

• Strong written and verbal communication skills
• Proficiency in Microsoft Office (especially Outlook, Teams, Word, Excel)
• Familiarity with Citrix and compliance tracking tools
• Detail-oriented, self-motivated, and comfortable working independently

Job Details

• Seniority level: Mid-Senior level
• Employment type: Contract
• Job function: Other
• Industries: Hospitals and Health Care