Senior Health Plan Compliance Analyst ACA Expert

Parkland Health and Hospital System (PHHS); Dallas (TX); Hybride; USD 90 000 - 130 000; Plein temps

Résumé du poste

Parkland Health and Hospital System is seeking a Health Plan Compliance Manager to oversee policy Development, evaluation of regulatory changes, and operationalization of ACA/Marketplace requirements. The role emphasizes strong communication, data-driven monitoring, and collaboration across legal, contracting, and provider relations teams.

The ideal candidate will have a CHC certification, 5+ years in healthcare compliance, and experience with reporting processes and CMS/TDI guidance.

Qualifications

• Bachelor's degree in Healthcare Administration, Business Administration or related field.
• Five years of relevant healthcare compliance experience.
• Experience designing and implementing reporting processes and structures for compliance.

Responsabilités

• Ensures work is carried out in compliance with regulatory and accreditation standards.
• Applies ACA/Marketplace regulations including 45 CFR Parts 153, 155, and 156.
• Prepares, coordinates, and tracks regulatory filings and submissions (SERFF).
• Attends regulatory agency meetings and tracks action items.
• Develops compliance committee agendas, presentations, and minutes.
• Maintains log and reporting of internal monitoring and compliance risks.
• Assists with compliance risk assessment and monitoring work plan.
• Tracks regulatory notices and guidance from CMS and TDI.
• Develops compliance education for Health Plan personnel.
• Builds collaborative relationships across departments and promotes ethical standards.

Connaissances

Verbal communication

Written communication

Interpersonal skills

Analytical skills

Problem solving

Time management

Organizational skills

Microsoft Office

ACA knowledge

NCQA knowledge

Texas Insurance Code

Formation

Bachelor's degree in Healthcare Administration or related field

Master's degree in Healthcare Administration or related field

Outils

SERFF

Regulatory databases

Description du poste

Parkland Health and Hospital System is seeking a Health Plan Compliance Manager to oversee policy Development, evaluation of regulatory changes, and operationalization of ACA/Marketplace requirements. The role emphasizes strong communication, data-driven monitoring, and collaboration across legal, contracting, and provider relations teams.

The ideal candidate will have a CHC certification, 5+ years in healthcare compliance, and experience with reporting processes and CMS/TDI guidance.