Associate Compliance Analyst

Description

American Specialty Health Incorporated (ASH) is seeking an Administrative Compliance Analyst to join our Regulatory & Program Compliance department.
The primary purpose of this position is to support the company's national regulatory compliance efforts. Note: The individual in this position is not intended to practice law or provide legal advice.

Hourly Salary Range 

American Specialty Health complies with state and federal wage and hour laws and compensation depends upon candidate’s qualifications, education, skill set, years of experience, and internal equity. $23.15 to $24.00 Hourly Wage Range. 

Remote Worker Guidelines

• Remote Worker Guidelines: This position will be trained remotely and must be able to work from home (WFH) in a designated work area with company-provided technology equipment. This WFH position requires you have a stable connection to your Internet Service Provider with the ability to participate by video in online meetings over a reliable and consistent network. The internet connection must have a consistent 50 down/10 up Mbps minimum internet speed. 100 down/20 up is recommended to support higher quality video meetings.

Responsibilities

• Supports Regulatory and Program Compliance Department activities by focusing on the following key accountabilities in relation to 4 - 8 assigned states.
  • Maintains required business licenses in a constantly changing regulatory environment. With oversight from Manager, develops understanding of the business need for each license and its licensing requirements for each license in their assigned states. Consults with Manager to resolve issues and to mitigate associated risks.
  • Coordinates and assists with external communication with regulatory agencies. Consults with Manager regarding outcome of communication. Educates external contacts regarding unique aspects of ASH’s business practices. Consults with Manager to resolve any issues and to mitigate associated risks.
  • Communicates and coordinates internally with various departments to understand operations and to communicate regulatory enforcement expectations of such operations including communicating courses of action, and with oversight from Manager, interpreting and translating enforcement expectations to current business practices. Effectively communicates with internal departments to obtain necessary information for regulatory filings based on the needs of each regulatory agency, in part by educating internal contacts on the unique regulatory environments in assigned states. Consults with Manager to resolve any issues and to mitigate associated risks.
  • Acquires subject matter knowledge on regulatory enforcement expectations in assigned states in a constantly evolving regulatory environment
  • Assists with research, communicates and coordinates regulatory compliance issues across multiple disciplines and levels of workforce (i.e. communicates well with staff ranging from entry level to senior executive level personnel).
  • Effectively monitors legislative and regulatory activity impacting company operations in assigned states. Completes comprehensive legislative and regulatory reports for assigned states that includes initial assessment of impact to business operations, consulting with Manager to resolve high level or complex regulatory compliance issues. Effectively communicates such regulatory changes to organization through written communication and verbal presentations to designated committees and senior management.
  • Under direction from Manager, performs research, initial analysis and summarization of regulatory compliance issues. Recommends courses of actions regarding regulatory compliance issues and presents recommendations to internal stakeholders. Resolves ad-hoc compliance issues. Consults with Manager to resolve complex regulatory compliance issues.
  • Supports and compiles documents for regulatory filings based on knowledge of unique regulatory framework while meeting required deadlines; such filings include, but are not limited to, the following: license applications, license renewals, financial filings, inquiry/complaint responses and regulatory market surveys for annual and quarterly reports.
  • Supports department with regulatory compliance projects that impact regional and national service areas.
• Supports regulatory compliance efforts for the company by focusing on the following:
  • Coordinates projects and develops subject matter knowledge of specific compliance areas impacting assigned states and business operations specific to those states as directed by management.
  • Assumption of responsibility for additional states as directed by management either on a transitional basis or as needed.
  • Assists with training of new employees and other department staff as needed on a project basis at the direction of management.
  • Under the supervision of Manager, assists with completion of multi-state, national or product implementation research projects.
• Supports the company’s overall activities by focusing on the following:
  • Assists with the administration of the Regulatory Reporting Work Group; including finalizing the agenda and preparing minutes.
  • Immediately informs Manager of urgent issues and provides timely assignments status updates.
  • Represents the company in an ethical, professional, and positive manner and complies with all company policies and procedures.
  • Maintains confidentiality of all company information and uses discretion in discussing regulatory compliance issues with internal and external contacts.
  • Maintains computer and system skills necessary to perform job functions.
  • Strictly adheres to department administrative guidelines including, but not limited to, guidelines regarding project tracking and record keeping practices.
  • Completes all ASH University training requirements, including required regulatory trainings, as well as ad hoc trainings required by management, within required time frames.
• Performs other duties as assigned.
• Complies with all policies and standards.

Qualifications

• Bachelor’s Degree in Health Care Policy or Administration, Law, English or equivalent experience required. If equivalent experience, High School Diploma required.
• 1 year regulatory compliance experience, preferably in a health insurance or managed care environment required. Experience to include monitoring legislative and regulatory requirements, maintaining regulatory licenses and coordinating and completing related filings, communicating with regulatory agencies, and assisting with regulatory compliance research.
• Experience with health insurance or managed care contracts preferred.
• Experience with Medicare and Medicaid preferred.
• Proficient in MS Office, with intermediate knowledge of Word and Excel; and proficient in use of Internet, SharePoint, and CRM databases.
• Understanding of Regulatory Agency operations, e.g., Department of Insurance, Department of Health, etc. Understanding of Commercial, Medicare, and Medicaid health care compliance preferred.
• Strong analytical and writing skills.
• Willingness to develop research skills.
• Understanding of ASH systems, policies and procedures preferred.

Core Competencies

• Demonstrated ability to interact in a positive, respectful manner and establish and maintain cooperative working relationships.
• Ability to display excellent customer service to meet the needs and expectations of both internal and external customers.
• Excellent listening and interpersonal communication skills to identify critical core competencies based on success factors and organizational environment.
• Ability to effectively organize, prioritize, multi-task and manage time.
• Demonstrated accuracy and productivity in a changing environment with constant interruptions.
• Demonstrated ability to analyze information, problems, issues, situations, and procedures to develop effective solutions.
• Ability to exercise strict confidentiality in all matters.

Mobility

• Primarily sedentary, able to sit for long periods of time.

Physical Requirements

• Ability to see, speak, and hear other personnel and/or objects. Ability to communicate both in verbal and written form. Ability to travel within and around the facility or Work from Home (WFH) environment. Capable of using a telephone, computer keyboard, and mouse. Ability to lift up to 10 lbs.

Environmental Conditions

• Work-from-home (WFH) environment.

American Specialty Health is an Equal Opportunity/Affirmative Action Employer.

All qualified applicants will receive consideration for employment without regard to sex (including pregnancy, childbirth, related medical conditions, breastfeeding, and reproductive health decision-making), gender, gender identity, gender expression, race, color, religion (including religious dress and grooming practices), creed, national origin, citizenship, ancestry, physical or mental disability, legally-protected medical condition, marital status, age, sexual orientation, genetic information, military or veteran status, political affiliation, or any other basis protected by applicable local, federal or state law.
Please view Equal Employment Opportunity Posters provided by OFCCP here.
If you are a qualified individual with a disability or a disabled veteran, you have the right to request an accommodation if you are unable or limited in your ability to use or access our career center as a result of your disability. To request an accommodation, contact our Human Resources Department at (800) 848-3555 x6702.
ASH will not discharge or in any other manner discriminate against employees or applicants because they have inquired about, discussed, or disclosed their own pay or the pay of another employee or applicant. However, employees who have access to the compensation information of other employees or applicants as a part of their essential job functions cannot disclose the pay of other employees or applicants to individuals who do not otherwise have access to compensation information, unless the disclosure is (a) in response to a formal complaint or charge, (b) in furtherance of an investigation, proceeding, hearing, or action, including an investigation conducted by the employer, or (c) consistent with the Company’s legal duty to furnish information.

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