Lead portions of regulatory assessments, external audits, and accreditation processes for Commercial, Medicare, Medicaid, and Marketplace departments.
Act as primary point of contact for internal and external partners on regulatory activity, quality efforts, SOP development, and client delegation agreements.
Maintain regulatory gap status reporting, track work streams, and lead change management related to regulatory requirements.
Collaborate with business stakeholders to perform root cause analysis.
Develop job aids, playbook, and other program documentation.
SmithRx is a Health-Tech company disrupting the Pharmacy Benefit Management industry with a technology-driven platform. The venture-backed company has hundreds of thousands of members and fosters a collaborative, mission-driven culture.
Manage end-to-end company licensing and regulatory support activities for healthcare facilities and laboratories.
Prepare, submit, and track license applications, renewals, and maintain compliance with federal and state requirements.
Collaborate with internal teams and external agencies to ensure accurate documentation and regulatory adherence.
Groups is a healthcare company that provides substance use disorder treatment and related services. The company operates remotely with a focus on compliance and regulatory support, maintaining a collaborative culture.
Manage regulatory inquiries of PLICO and affiliated insurance companies.
Respond to inquiries from regulatory bodies for insurance and securities activities.
Partner with business and divisional compliance units to coordinate regulatory filings.
Protective helps protect customers against life's uncertainties. The company is a large insurance provider with a strong focus on employee well-being and a collaborative culture.
Analyze regulatory frameworks and licensing requirements across multiple jurisdictions.
Translate complex regulatory requests into structured compliance analyses and client deliverables.
Collaborate with engineering and legal teams to develop scalable compliance workflows and knowledge assets.
Our partner is a technology company focused on compliance and digital assets. They operate in a collaborative, international, and fully remote environment with a multidisciplinary team.
Lead the development and improvement of product compliance programs, including policies, procedures, and monitoring frameworks.
Apply regulatory judgment to complex compliance issues, conduct risk assessments, and support corrective actions.
Leverage AI-enabled tools to enhance compliance documentation and analysis, while collaborating with cross-functional teams.
The company provides an AI-powered job matching platform for candidates and employers. It is a partner-driven organization that focuses on compliance solutions in healthcare, with a small to medium size, offering remote work flexibility and a culture of continuous improvement.
Lead multi-state expansion and regulatory compliance for a health insurance carrier.
Own rate and form filings, licensing, and regulatory relations with state Departments of Insurance.
Build, implement, and maintain compliance policies, monitoring programs, and risk reporting.
Evry Health is a large group health insurance carrier focused on multi-state expansion and regulatory compliance. The company is a lean, fast-moving organization with a remote-first culture, seeking a foundational hire to build its compliance function.
Lead one or more client policy initiatives with a team, including policy analysis, client communications, and project tracking.
Drive your development through an annual growth process in partnership with your supervisor and the learning and development team.
Participate in new business development through research, proposal content, and marketing materials.
BerryDunn is a professional services firm that has helped businesses, nonprofits, and government agencies since 1974. The firm is client-centered and people-first, with a focus on learning, development, and well-being, and has been recognized for its diverse and inclusive workplace culture.
Lead advanced Product Compliance activities to ensure administrative solutions align with laws and regulations.
Apply expert regulatory judgment to complex compliance inquiries and escalations using AI-enabled tools.
Partner with stakeholders to incorporate compliance requirements into strategic initiatives and operational changes.
HealthEquity is dedicated to saving and improving lives by empowering healthcare consumers through health savings accounts and related solutions. The company is a mid-to-large size organization that fosters a culture of inclusion, innovation, and continuous learning.
Lead compliance functions for self-funded health plans, ensuring regulatory adherence across plan administration, filings, and vendor relationships.
Manage regulatory filings including SPDs, Form 5500, and PCORI fees, and act as primary compliance liaison with TPAs, PBMs, and carriers.
Develop and maintain internal compliance policies, provide training, and serve as HIPAA Privacy and Security Officer.
Vitable is a health benefits platform designed for every worker, making it easy for employers to offer high-quality healthcare to their teams. They are a small, passionate team moving fast and solving a problem that genuinely deserves solving.
Serve as a trusted regulatory advisor to skilled nursing and assisted living providers nationwide, monitoring and interpreting industry changes.
Develop and deliver educational content including webinars, presentations, articles, and social media thought leadership.
Conduct regulatory research, client data analysis, and onsite/offsite reviews to provide actionable recommendations.
Polaris Group, part of the Assembly Health family, provides regulatory consulting to skilled nursing and assisted living providers. Their team is client-focused, growth-oriented, and emphasizes excellence, integrity, and collaboration.
Review healthcare claims and determine appropriate payment methodologies based on contractual terms and client requirements.
Analyze claim information and system data to ensure accurate repricing while meeting productivity and quality metrics.
Collaborate with internal audit and operational teams to support compliance, quality assurance, and process improvement initiatives.
The company provides healthcare claims review and repricing services. It operates remotely with a focus on compliance, accuracy, and continuous improvement.
Lead compliance and regulatory reporting initiatives in a fast-paced, remote environment.
Coordinate cross-functional teams to define reporting requirements and ensure accurate delivery.
Drive improvements in reporting processes, operational efficiency, and data-driven decision-making.
The company operates in a highly regulated healthcare environment, focusing on compliance and reporting. It offers a collaborative, fast-paced remote culture with a focus on innovation and operational improvement.
Assist in preparing and reviewing regulatory submissions and manage transmission through FDA ESG.
Maintain submission archive, trackers, and regulatory document templates.
Collaborate with cross-functional teams on product labeling and ensure compliance.
Loyal is a clinical-stage veterinary medicine company developing longevity drugs for dogs. We are a well-funded startup with teams of scientists, veterinarians, engineers, operators, and creatives.
Supervise daily operations of clinical compliance auditors and specialists.
Assist in developing coordinated team processes and managing UM and PHM plan adherence.
Serve as clinical services liaison to senior management and ensure timely documentation.
Guidehealth is a data-powered healthcare company focused on operational excellence and value-based care. They emphasize empathy, AI, and collaboration, with a remote-first culture.
Manage client medical payment policies to ensure accuracy and compliance with CMS and payer guidelines.
Conduct periodic reviews and analyses of policy updates, coordinating with Medical Directors and presenting recommendations to clients.
Serve as the primary client liaison, addressing inquiries and maintaining detailed documentation of policy nuances.
Cotiviti is a healthcare data analytics company specializing in payment accuracy and medical policy management. The company fosters a collaborative remote culture and offers competitive benefits to support its team.
Interpret Medicaid regulatory, Program Integrity, and Third-Party Liability (TPL) requirements to support compliance assessments and audit readiness.
Develop recommendations and corrective action approaches to address compliance findings and support responses to CMS and state agencies.
Collaborate with cross-functional teams to align findings, prioritize follow-up activities, and coordinate recommendations for process improvements.
BerryDunn is a client-centered, people-first professional services firm that has helped businesses, nonprofits, and government agencies since 1974. With a focus on creating a diverse and inclusive workplace, the firm is recognized for its commitment to learning, development, and well-being.
Serve as a trusted compliance advisor across benefit products, ensuring regulatory alignment while supporting innovation and operational excellence.
Review marketing materials, customer communications, and product documentation to ensure regulatory accuracy and consumer protection compliance.
Lead compliance risk assessments for new product features, workflow changes, and emerging technologies, including AI-powered solutions.
They provide innovative healthcare benefit products and financial wellness solutions. The company offers a collaborative, fast-paced environment with a focus on regulatory excellence.
Maintain accurate caregiver supervision records within HHA Exchange (HHAX) and ensure proper documentation of nursing supervisory visits.
Update caregiver compliance profiles, upload supervision forms, and verify documentation for accuracy and completeness.
Communicate with clinical staff regarding incomplete documentation and assist with audits and compliance-related tasks.
Limitlessli specializes in recruiting, hiring, and managing high-caliber remote staff for dynamic healthcare facilities. They leverage a global network to connect clients with qualified professionals, offering tailored services to meet unique business needs.
Manage the healthcare compliance program and provide advice on regulations governing drug development and commercialization.
Develop and maintain policies, training, and monitoring activities to ensure compliance with FDA, OIG, and CMS rules.
Advise on interactions with healthcare professionals, fair market value, and transparency reporting under the Sunshine Act.
Coherus Oncology is a commercial and clinical stage biotech company. It offers a collaborative, results-driven environment with a focus on healthcare compliance and teamwork.
Eligibility Review: Review patient records and clinical documentation to determine eligibility for Form Health.
Record Collection: Manage requesting, faxing, and tracking medical records from external providers while ensuring HIPAA compliance.
File Communication: Maintain clear communication with patients and colleagues to keep them updated throughout the eligibility process.
Form Health is a virtual obesity medicine clinic that provides multi-disciplinary evidence-based obesity treatment through telemedicine. Founded in 2019, it is a venture-backed startup with an experienced clinical and leadership team, committed to a culture of inclusion and patient-first values.