reviews and analyzes new and existing laws, regulations and policies for their impact on the Medicaid line of business.
monitors and helps to ensure compliance with regulations in accordance with the specific areas they support.
educates Compliance associates on regulatory and legal issues.
reviews and monitors policies and procedures to ensure compliance with regulations.
may help draft policies and procedures in response to changes and updates of specific laws and regulations.
assists with the implementation of new policies and procedures that affect compliance.
researches and analyzes regulatory requirements as needed to ensure compliance.
interprets regulations regarding benefits and provides information and education to Health Plan associates.
monitors compliance in regard to regulatory related communications including training and manuals.
assists with informing management and Health Plan associates of changes or updates to regulatory requirements.
assists in the coordination of responses for Corrective Action Plans, inquiries, follow-up, reporting and any other requests.
assists in the preparation of materials and requirements for regulatory audits.
may act as subject matter expert in reviews of Request for Proposals (“RFPs”) and non-standard contracts with large employer groups.

Compliance Analyst

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