Sr. Regulatory Compliance Analyst

KMM Technologies, Inc.; Herndon (VA); Remote; USD 100,000 - 130,000; Full time

Job summary

A leading company is seeking a Sr. Regulatory Compliance Analyst to ensure compliance with state and federal regulations. Key responsibilities include conducting regulatory inquiries, auditing internal controls, and maintaining pharmacy compliance materials. The ideal candidate will possess strong communication skills and a Bachelor's degree along with significant experience in compliance roles.

Qualifications

• 5 years experience in compliance or senior level customer service role.
• Excellent critical thinking and communication skills both written and verbal.
• Must be able to interpret insurance laws and regulations.

Responsibilities

• Conduct independent analysis for regulatory inquiries and provide compliance guidance.
• Audit internal controls to identify risk exposures and track remedial solutions.
• Maintain compliance of external pharmacy materials and monitor updates to regulations.

Skills

Regulatory compliance

Content accuracy and auditing

Cross-functional coordination

Risk mitigation

Written communication

Education

Bachelor's Degree

Job description

Join to apply for the Sr. Regulatory Compliance Analyst role at KMM Technologies, Inc.

Join to apply for the Sr. Regulatory Compliance Analyst role at KMM Technologies, Inc.

Get AI-powered advice on this job and more exclusive features.

Position: Sr. Regulatory Compliance Analyst

Location: Reston, VA #REMOTE

Duration: 12Months #C2H

Job Description

• The Senior Regulatory Compliance Analyst will conduct independent analysis for complicated, high level regulatory inquiries and provide interpretation of regulatory rules and guidelines to demonstrate compliance with state and federal requirements.
• The incumbent will audit internal controls to identify high risk exposure, will provide recommendations to business areas and will track implementation of remedial solutions.
• This role ensures that all external and member-facing pharmacy materials meet compliance standards. Responsibilities include:
• Monitor updates to federal and state regulations (e.g., CMS, URAC, state mandates) and ensure pharmacy content remains current.
• Review and approve all pharmacy-related communications for compliance, accuracy, and timeliness.
• Coordinate with legal, regulatory, and compliance teams to validate communication strategies and mitigate risk.
• Maintain documentation and version control for all regulated pharmacy communications.
  
  

Top 5 Mandatory Skills

• Regulatory compliance Deep understanding of CMS, URAC, state requirements, and other pharmacy compliance standards.
• Content accuracy and auditing Reviewing and validating content to ensure clarity, consistency, and alignment with requirements.
• Cross-functional coordination Partnering with legal, regulatory, and other internal teams to review and maintain standards.
• Risk mitigation Identifying and addressing gaps in pharmacy communications.
• Written communication High-quality, accurate writing and editing of regulated communications.
  
  

Qualifications

• Education Level: Bachelor's Degree
• 5 years experience in a compliance or senior level customer service role.
• Skill in using logic and reasoning to identify the strengths and weaknesses of alternative solutions, conclusions, or approaches to problems., Advanced
• Ability to convey information in a clear, concise, and logical manner., Advanced
• Ability to effectively convey information to others., Advanced
• Excellent critical thinking and communication skills both written and verbal. , Advanced
• Consistently maintains highly professional written and verbal interaction with all levels of staff within the company and with members of regulatory agencies., Advanced
• Must be able to interpret insurance law and regulations. , Advanced
  
  

Essential Functions

30% Relationship Management: (Internal/External)

Liaison with Regulatory Agency Investigators (Maryland Insurance Administration {MIA}, Virginia Bureau of Insurance {VBOI} and the District Insurance, Security and Banking {DISB}, organization as well as state and federal level bureaucrats. Frequent interaction with all internal areas especially all Business Units, Legal, Compliance and Legislative Departments. Provide interpretation of regulations and regulatory rules/guidelines to demonstrate and its subsidiaries' compliance with state and federal standards. Review and analyze all data received in order to generate detailed responses to the originating party. Strategizes with Legal and Compliance as needed to identify the best response to the complaint. Consistently maintains highly professional written and verbal interaction with all levels of staff within the company and with all members within regulatory departments. Maintain positive, responsive, respectful relationships with all regulators. Serves as the subject matter expert for business processes and related systems as the representative of the company. Provide education regarding systems and process to regulators as needed and requested.

30%: Business Support

Research, resolve and respond to written inquiries forwarded from Congressional, Attorney General and State officials, members, providers, groups and brokers. Coordinate with internal and external parties to ensure accurate information is obtained. Review and analyze provided data and information. Provide detailed professionally written responses to originating party, ensuring all questions are answered and customer needs are effectively served within designated timeframes while ensuring privacy needs of members are respected. Review, analyze, prepare detailed documentation for support of legal action pertaining to indemnity business, ensuring that all appropriate materials, related claims, contracts, payment vouchers are included. Develop a summary/assessment of included documentation for legal staff. Meet, discuss, and strategize with legal staff to prepare for depositions, court cases or administrative hearings.

15% System Compliance Analysis

Review moderately complex business processes and systems to identify, document, elevate the presence of risks and trends within systems and processes that may be non-compliant with contracts and or statutory requirements especially in the claims processing, enrollment and service arenas all jurisdictions, all products, all processing platforms to include our subsidiaries. Actively participate in implementation/corrective workgroups to ensure compliance perspective and concerns are addressed through the process.

15% Litigation and Legal Support

Review, analyze, prepare detailed documentation for support of legal action pertaining to indemnity business, ensuring that all appropriate materials, related claims, contracts, payment vouchers are included. Develop a summary/assessment of included documentation for legal staff. Meet, discuss, and strategize with legal staff to prepare for depositions, court cases or administrative hearings.

10% Special Projects

Provide research, investigative and analytic support on special projects ensuring that all policies and contractual guidelines are clearly identified. Provide support to supervisors and other internal associates with written responses to inquiries.

Thanks & Regards,

• LAXMAN KMM Technologies, Inc. CMMI Level 2 | ISO 9001 | ISO 20000 | ISO 27000 Certified

Seniority level

• Seniority level

  Mid-Senior level

Employment type

• Employment type

  Full-time

Job function

• Job function

  Finance and Sales

Referrals increase your chances of interviewing at KMM Technologies, Inc. by 2x

Get notified about new Regulatory Compliance Analyst jobs in Herndon, VA.

Washington, DC $100,000.00-$130,000.00 1 week ago

Compliance Specialist, Last Mile Legal, WW Ops

Arlington, VA $66,800.00-$142,800.00 1 week ago

Competition and Consumer Protection Compliance Specialist

Washington, DC $131,000.00-$192,000.00 1 day ago

Regulatory Compliance Analyst - R10197038

McLean, VA $73,900.00-$110,900.00 1 week ago

Washington, DC $115,200.00-$216,600.00 1 week ago

Compliance Analyst, Regulatory Compliance, AWS Compliance & Security Assurance

Washington DC-Baltimore Area $150,000.00-$170,000.00 3 days ago

Washington, DC $153,600.00-$287,280.00 17 hours ago

McLean, VA $60,000.00-$70,000.00 4 months ago

Regional Compliance Specialist (Mid-Atlantic)

Washington, DC $70,000.00-$94,000.00 2 weeks ago

Competition and Consumer Protection Compliance Senior Analyst

Washington, DC $107,000.00-$153,000.00 1 day ago

International Trade & Compliance Counsel

Senior Specialist, Compliance and Base Supply Centers

Hyattsville, MD $65,000.00-$85,000.00 2 weeks ago

District of Columbia, United States $175,000.00-$250,000.00 1 week ago

Kensington, MD $62,964.00-$103,295.00 6 months ago

We’re unlocking community knowledge in a new way. Experts add insights directly into each article, started with the help of AI.