Apply on Employer Site

Innova Solutions · 1 day ago

Regulatory Performance Analyst

Philadelphia, PA

Contract

Onsite

Mid Level

$41/hr - $43/hr

3+ years exp

Innova Solutions is a global leader in technology and business transformation solutions, seeking a Regulatory Performance Analyst to join their team. The role involves identifying compliance issues in operational performance areas of a major health insurance issuer and providing regulatory guidance to operational teams.

Artificial Intelligence (AI)Business Information SystemsCloud Data ServicesConsultingCyber SecurityInformation TechnologyInfrastructureIT ManagementMachine LearningSoftware

Responsibilities

Responsible for identifying, documenting, and tracking the resolution of compliance issues in operational performance areas (e.g. billing, enrollment, claims) of a major health insurance issuer

Responsible for research state and federal laws relating to the Affordable Care Act, providing key insights to guide our operations

Regulatory Analysis: Interpret and analyze federal and state regulatory requirements, providing clear regulatory guidance to operational teams and ensuring effective implementation of new laws and regulations

Corrective Action Plan (CAP) Tracking: Leverage compliance tracking software to document CAPs and develop remediation plans, ensuring alignment with regulatory standards

Maintain regular updates on disclosed issues

Operational Collaboration: Work closely with business areas to address compliance gaps, ensuring that they are taking appropriate ownership of any CAPs under their purview, thoroughly analyzing root cause, providing evidence remediation, and documenting updated processes in policies and procedures

Proactive Monitoring: Analyze indicators, identify trends, and monitor potential compliance risks, escalating issues and driving resolution as needed