Regulatory Compliance Analyst III – Workers Comp, Commercial Programs

🌍 Remote, USA 🚀 Full-time 🕐 Posted Recently

Job Description

Monitor and analyze federal and state laws and guidance affecting CareCentrix’s workers’ compensation, auto, and commercial program operations.
Prepare and distribute clear written and verbal communications to impacted business areas.
Provide cross‑functional support, guidance, and direction in developing policies, procedures, and operational changes required for legal and regulatory compliance.
Partner with operational teams to implement these changes effectively.
Secure and maintain all required operational licenses.
Support the onboarding and implementation of new CareCentrix workers’ compensation, auto, and commercial program clients.
Identify and drive continuous improvement initiatives to enhance compliance tracking, trending, and reporting capabilities.
Conduct internal audits as needed and identify opportunities for process improvement.
Develop and deliver training programs to ensure teams fully understand compliance requirements.

Bachelor’s degree preferred, or a minimum of 5 years of experience in a managed care setting working with laws impacting workers’ compensation, auto, and/or commercial health insurers and delegated entities.
This includes experience with regulations governing utilization management, claims, network management, and credentialing.
Demonstrated experience in regulatory affairs and/or the operations of HMOs, managed care organizations, or other insurers.
Proficiency in Microsoft Office applications, including Excel, SharePoint, PowerPoint, and OneNote.
Advanced legal research abilities; strong organizational and analytical skills; excellent written, verbal, and presentation communication skills; and exceptional attention to detail.
Requires in-depth knowledge of state and federal workers’ compensation, auto, and/or commercial managed healthcare regulations and guidelines.