Regulatory Performance Analyst

Regulatory Compliance Analyst

We are seeking a highly analytical and detail-oriented Regulatory Compliance Analyst to support compliance initiatives within a leading health insurance organization. This role will be responsible for researching and interpreting state and federal healthcare regulations, identifying compliance risks, tracking remediation efforts, and partnering with operational teams to ensure adherence to regulatory requirements.

The ideal candidate is an independent problem solver with strong research, analytical, and communication skills who can translate complex regulations into actionable guidance for business stakeholders. Experience within managed care, health insurance operations, or legal/regulatory environments is highly preferred.

Key Responsibilities

• Research and interpret state and federal healthcare regulations, including Affordable Care Act requirements, to provide guidance and support compliance initiatives.
• Identify, document, and track compliance issues across operational areas including claims, billing, enrollment, and healthcare operations.
• Manage Corrective Action Plan (CAP) tracking, ensuring remediation activities are documented, monitored, and aligned with regulatory standards.
• Partner with business teams to analyze root causes, develop remediation strategies, and document process improvements.
• Monitor compliance trends, identify potential risks, and escalate issues requiring additional review or action.
• Support updates to policies, procedures, and operational documentation to ensure regulatory alignment.
• Maintain accurate compliance records and provide reporting on issue resolution and ongoing risk management.
  
  

Qualifications

• Bachelor’s degree or equivalent professional experience.
• 3 years of experience in healthcare, managed care, health insurance, compliance, regulatory affairs, or a related field.
• Strong understanding of healthcare regulations, including Affordable Care Act requirements preferred.
• Experience with compliance monitoring, regulatory research, audits, or corrective action plans strongly preferred.
• Exceptional written and verbal communication skills with the ability to communicate complex information clearly.
• Strong analytical, organizational, and problem-solving abilities.
• Advanced proficiency with Microsoft Office applications, including Outlook, Teams, Word, and Excel.
• Ability to work independently, manage multiple priorities, and adapt in a fast-paced environment.
  
  

Preferred Qualifications

• Legal background, JD, paralegal experience, or regulatory research experience.
• Experience working within a health plan, managed care organization, or payer environment.
• Familiarity with compliance tracking systems and healthcare operational processes.
  
  

This is an excellent opportunity for a compliance-focused professional who enjoys researching regulations, solving complex problems, and partnering with business teams to improve healthcare operations and ensure regulatory excellence.