SQL-Driven Regulatory Reporting Analyst (PBM)

ProCare Rx; Gainesville (GA); On-site; USD 70,000 - 100,000; Full time

Job summary

ProCare Rx is seeking a Regulatory Reporting Analyst to monitor state and federal filing requirements, build SQL-based reports, and coordinate CMS/URAC submissions. You will collaborate with Legal, Rebates, and Finance to translate complex regulations into clear reporting specifications.

The ideal candidate has 2+ years in regulatory reporting within healthcare payer environments, strong SQL and Excel skills, and excellent communication to explain regulatory concepts to non-technical

Qualifications

• Bachelor's degree or equivalent work experience in a related field.
• 2+ years in regulatory reporting, compliance, or data analysis in PBM/healthcare.
• SQL proficiency to write and troubleshoot complex queries against large datasets.
• Knowledge of PBM operations and terminology (claims adjudication, eligibility, formulary, rebates).
• Detail-oriented with ability to manage multiple deadlines across states.
• Excellent written and verbal communication to explain regulatory concepts.
• Excel proficiency for data validation and ad hoc analysis.

Responsibilities

• Monitor and track state regulatory requirements from legal team.
• Prepare and submit annual CMS CAA RxDC reporting for ProCare.
• Lead URAC accreditation reporting and data validations with auditors.
• Build and maintain SQL queries and data extracts from claims, eligibility, pricing data.
• Create a master calendar of all filing deadlines and ensure on-time submissions.
• Validate report accuracy and reconcile against source systems.
• Maintain documentation of report logic and data sources.
• Serve as primary contact for regulator inquiries and data requests.
• Collaborate with Legal, Rebates, and Finance to translate regulations into reports.
• Identify opportunities to automate recurring regulatory reports.
• Track and report status of open regulatory obligations to leadership.

Skills

SQL proficiency

Regulatory reporting

Data analysis

Attention to detail

Excel skills

Verbal communication

Education

Bachelor's degree in Healthcare Administration, Business, Finance, Information Systems, or related

Tools

QlikView

Power BI

Tableau

Job description

ProCare Rx is seeking a Regulatory Reporting Analyst to monitor state and federal filing requirements, build SQL-based reports, and coordinate CMS/URAC submissions. You will collaborate with Legal, Rebates, and Finance to translate complex regulations into clear reporting specifications.

The ideal candidate has 2+ years in regulatory reporting within healthcare payer environments, strong SQL and Excel skills, and excellent communication to explain regulatory concepts to non-technical