Senior Associate, Government Programs Compliance and Regulatory

Ankura; Lake Michigan Beach (MI); Remote; USD 85.000 - 125.000; Vollzeit

Benefits dieser Stelle

Remote work

Zusammenfassung

Ankura seeks a Senior Associate to support client engagements on compliance, regulatory, and operational matters across Medicare Advantage, Medicaid managed care, and ACA programs. The role involves regulatory research, data analysis, and developing findings, workpapers, reports, and presentations.

You will translate CMS guidance and state requirements into practical health plan operations and collaborate with project leaders.

Qualifikationen

• Bachelor’s degree required; 3–5 years in health plan compliance/regulatory affairs/consulting.
• Experience with Medicare Advantage, Medicaid managed care, or ACA programs preferred.
• Strong ability to translate CMS guidance and contractual requirements into practical operations.
• Excellent written and verbal communication; ability to deliver clear analyses and client deliverables.

Aufgaben

• Conduct regulatory research on federal/state requirements for Medicare Advantage, Medicaid, and ACA programs.
• Interpret CMS guidance and contracts to evaluate impact on health plan operations.
• Review policies, procedures, and data for compliance with applicable requirements.
• Identify gaps/risks and communicate findings to engagement leadership.
• Develop workpapers, reports, and client deliverables with clear, supported conclusions.
• Lead defined project workstreams and coordinate activities to meet timelines.
• Collaborate with Project Managers and engagement leaders to align objectives and plans.
• Provide guidance on junior team members’ work and support high-quality deliverables.

Kenntnisse

Analytical thinking

Communication skills

Problem-solving

Time management

Team collaboration

Ausbildung

Bachelor's degree

Tools

Microsoft Excel

Microsoft Word

PowerPoint

Jobbeschreibung

Ankura is a team of excellence founded on innovation and growth.

Role Overview

Ankura is seeking a Senior Associate to support client engagements involving compliance, operational, and regulatory matters across Medicare Advantage, Medicaid managed care, and Affordable Care Act programs.

The Senior Associate will conduct regulatory research; analyze health plan data, documentation, policies, and operational processes; and develop findings, workpapers, reports, presentations, and other client deliverables. The successful candidate will understand how CMS guidance, state contractual requirements, and other regulatory expectations translate into day-to-day health plan operations.

Responsibilities

• Conduct research and analysis of federal and state regulatory requirements applicable to Medicare Advantage, Medicaid managed care, and Affordable Care Act programs.
• Interpret CMS guidance, state Medicaid contracts, regulatory communications, and other requirements to evaluate their impact on health plan operations.
• Review health plan policies, procedures, reports, data, operational documentation, and other supporting materials to assess compliance with applicable requirements.
• Analyze regulatory and operational issues, identify potential gaps or areas of risk, and communicate findings clearly to engagement leadership.
• Develop clear, accurate, and well-supported workpapers, findings, reports, presentations, and other client deliverables.
• Take ownership of defined project workstreams, including coordinating assigned activities, monitoring progress, and completing deliverables within established timelines.
• Work with Project Managers and other engagement leaders to understand client concerns, define project objectives, and develop effective work plans.
• Apply structured problem-solving and critical-thinking skills to complex regulatory, compliance, and operational questions.
• Communicate project updates, emerging issues, and findings to engagement leadership in a timely manner.
• Collaborate effectively with colleagues and client stakeholders to build and maintain strong working relationships.
• Review and provide guidance on work completed by junior team members, as appropriate.
• Support the successful completion of high-quality client deliverables within the desired timeframe.
• Contribute to practice development, internal knowledge sharing, and the continued development of tools, methodologies, and service offerings.
• Maintain the confidentiality of client information and understand the importance of privileged and confidential communications.

Qualifications

• Bachelor’s degree from an accredited college or university.
• Approximately three to five years of relevant experience in health plan compliance, regulatory affairs, health plan operations, consulting, or a related field.
• Experience working with Medicare Advantage, Medicaid managed care, Affordable Care Act programs, or other government-sponsored health care programs.
• Working knowledge of CMS guidance, state Medicaid contractual requirements, and the operational processes used by health plans to implement regulatory requirements.
• Experience conducting regulatory research and translating complex requirements into practical operational considerations.
• Experience analyzing health plan data, policies, procedures, documentation, or operational processes.
• Strong analytical, critical-thinking, and problem-solving skills.
• Demonstrated ability to develop clear, concise, and well-supported written analyses and client deliverables.
• Excellent written and verbal communication skills.
• Ability to manage multiple assignments, establish priorities, and meet deadlines in a client-service environment.
• Ability to work effectively both independently and as part of a collaborative engagement team.
• Experience supporting or guiding junior team members is preferred.
• Proficiency in Microsoft Excel, Word, and PowerPoint, including the ability to develop reports, workpapers, analyses, and presentations.
• Willingness to travel based on client and engagement needs.

Preferred Qualifications

• Consulting or professional services experience.
• Experience assessing health plan compliance with regulatory or contractual requirements.
• Experience with compliance audits, operational reviews, risk assessments, corrective action plans, and regulatory readiness activities.
• Familiarity with multiple functional areas of health plan operations.
• Experience interacting directly with clients or senior internal stakeholders.

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