Principal Analyst, Regulatory Operations (REMOTE)
Advantasure

Chicago, Illinois

Posted in IT


This job has expired.

Job Info


SUMMARY:

The Principal Analyst is responsible for planning, organizing, directing, implementation, and leading regulatory analysis and initiatives. This role researches, compiles, and analyzes appropriate and relevant regulatory requirements (multiple topics within Medicare Advantage, risk adjustment in the commercial/Affordable Care Act market) to track how these regulations shape CMS audit/compliance requirements. The ideal candidate will possess both the ability to review/analyze the latest regulations, but also have strong organization and communication skills to track/understand the impacts of this type of guidance on the organization.

RESPONSIBILITIES/TASKS:

  • Responsible for the development and delivery of multiple concurrent projects/programs that encompass business process design and improvement.
  • Accountable for supporting business teams to identify and deliver significant and quantifiable business improvements through process improvement methodologies.
  • Consults, develops, and ensures compliance according to CMS regulatory standards.
  • Initiates and leads problem solving efforts working closely with internal and external stakeholders.
  • Possesses and maintains an extensive comprehensive knowledge of Advantasure business, products, programs, corporate organizational structure (including functional responsibilities), and basic research principles/methodologies.
  • Manages and monitors multiple projects simultaneously by establishing project plans and objectives to ensure goal attainment within defined parameters.
  • Investigates, reviews, recommends, and communicates solutions which identify problems/root cause of issues.
  • Identifies and resolves challenges in order to fulfill key corporate objectives and responds to the demands of change management and initiates actions needed to plan, organize, and control team activities.
  • Independently develops and plans reports, papers, and/or other materials in a clear and concise manner.
  • Acts as a liaison between corporate business areas and participates in group or committee discussions.
This position description identifies the responsibilities and tasks typically associated with the performance of the position. Other relevant essential functions may be required.

EMPLOYMENT QUALIFICATIONS:

EDUCATION:

Bachelor's degree in Health Policy, Public Policy, Business Administration or a related field. Master's degree in a related field is preferred. Relevant combination of education and experience may be considered in lieu of degree. Continuous learning, as defined by the Company's learning philosophy, is required. Certification or progress toward certification is highly preferred and encouraged.

EXPERIENCE:

Seven years experience in a related field, typically in two subject areas (e.g. process improvement, project planning, health care policy, business decisions, analysis, or business management).

SKILLS/KNOWLEDGE/ABILITIES (SKA) REQUIRED:
  • Excellent analytical, planning, problem solving, verbal, and written skills to communicate complex ideas.
  • Ability to work independently, within a team environment, and communicate effectively with employees at all levels.
  • Excellent organization skills and ability to effectively multi-task in a dynamic and fast paced environment.
  • Ability to lead and facilitate cross functional team meetings.
  • Working knowledge of project management disciplines and methods.
  • Knowledge of MS Project or other project management tools.
  • Excellent knowledge and use of existing software packages (Visio, PowerPoint, Excel, Word).
  • Knowledge of Medicare Advantage regulations, especially regarding audit and compliance requirements (Claims, Enrollment, Appeals/Grievances, Part D).
WORKING CONDITIONS:

Work is performed in an office setting with no unusual hazards.

The qualifications listed above are intended to represent the minimum education, experience, skills, knowledge and ability levels associated with performing the duties and responsibilities contained in this job description.

We are an Equal Opportunity Employer. Diversity is valued and we will not tolerate discrimination or harassment in any form. Candidates for the position stated above are hired on an \"at will\" basis. Nothing herein is intended to create a contract.


This job has expired.

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