Compliance Analyst - Remote Nationwide

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Position:
Compliance Analyst - Remote Nationwide
Position Summary:
Assists in the daily operations of the organization's Compliance programs and compliance related activities. Utilizes a good understanding of regulations and company policies and procedures to perform a variety of duties that ensure regulatory requirements and operational policies and procedures are effectively implemented and monitored. Acts as an internal consultant to business operations to advise on compliance-related matters for assigned functional areas or processes. Responsible for integrating themselves within operations, attending various meetings, and working with business owners to understand the rules and to identify and lessen risks.
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Primary Responsibilities

• Prepares and/or reviews data universes and standardized reports for compliance with regulatory requirements. Assists with updating report templates and functionality when technical specifications or audit protocols change.
• Escalates potential or actual non-compliance, deficiencies, and/or risks that become known through various compliance activities for investigation, prevention, and/or corrective action.
• Reviews and revises various marketing and member materials and communications for compliance with regulatory and operational guidelines. Routes materials through appropriate workflows, including coordinating required approvals and submitted to regulator or client.
• Participates in various team and committee meetings. Contributes and offers guidance when warranted to ensure goals are achieved.
• Participates in compliance awareness and education activities. Helps develop/present specialized or customized compliance training relative to operational departments or processes for assigned business operations areas.
• Reviews, updates, and helps develop policies and procedures, evaluating compliance with regulatory requirements. Helps identify areas where new policies and procedures are needed.
• Participates in issue investigation, impact and/or root cause analysis, and/or corrective action plan development, implementation, or validation.
• Guides or participates in moderately complex compliance auditing activities, including learning the audit protocols/criteria applicable to each audit type; supporting mock audits and educating audit participants; coordinating audits; collecting, preparing, reviewing, tracking, submitting, and recordkeeping of requested information/data/documents; preparing/delivering audit summaries or reports; and working cross-functionally and with external vendors.
• Conducts research of laws, regulations, guidelines, contracts, policies and procedures, and other types of resources or documentation. Reviews and interpret such information in order to effectively identify compliance requirements. May create written summaries of regulations, rules, or protocols
• Compiles, reviews, and/or summarizes data. Monitors data against established criteria and identifies deficiencies/discrepancies, trends, issues, or risks. Prepares summary reports, dashboards, and observations for internal and external partners. Completes assigned routine monitoring activities in compliance with monitoring work plan.
• Serves as a resource and subject-matter expert for compliance questions and guidance for assigned business operations areas. Collaborates and work effectively with operational areas to review applicable regulations and apply to business functions, and to identify compliance risks and appropriate solutions or corrective actions.
• Other duties as assigned.

Qualifications

• Effective interpersonal and customer service skills with the ability to effectively interact at all levels internally and externally
• Bachelor's degree in business or related field or equivalent
• Ability to organize, plan, prioritize, execute, and track progress of work to meet deadlines while adapting to changing priorities
• Good computer skills, specifically with MS products with the ability to learn and apply new technologies
• 3+ years of related compliance or healthcare experience or the knowledge, skills, and abilities to succeed in the role
• Ability to research, review, and interpret State and Federal laws, regulations, and standards
• Firm critical thinking, investigatory, and problem-solving skills with the ability to identify risks and propose corresponding solutions
• Collaborative and team-oriented
• Knowledge of healthcare regulations
• Ability to interpret moderately complex processes and programs in a heavily regulated environment
• Strong communication and presentation skills with the ability to deliver training, educational materials, etc.
• Detail-oriented with excellent follow-through

Preferred

• Working knowledge of compliance best practices, as well as reporting, auditing, and monitoring techniques and standard
• Experience with interpreting, understanding, and implementing, monitoring, or auditing compliance/regulations
• Experience in Medicare Advantage, Medicaid, or heavily regulated environments

Working Conditions

• While performing the duties of this job, the employee works in normal office working conditions.

Disclaimer

• The job description describes the general nature and level of work being performed by people assigned to this job and is not intended to be an exhaustive list of all responsibilities, duties and skills required. The physical activities, demands and working conditions represent those an employee encounters while performing the essential functions of this job. Reasonable accommodations may be made to enable individuals with disabilities to perform the essential job duties and responsibilities.

Lumeris is an EEO/AA employer M/F/V/D.
The hiring range for this position is:
$53,500.00-$71,500.00
Factors that may be used to determine your actual pay rate include your specific skills, experience, qualifications, location, and comparison to other employees already in this role. This role may also be eligible for incentive compensation. At Lumeris, we are committed to providing a total rewards package that supports your overall well-being. Our benefits include medical, vision, dental, well-being programs, 401(k) with company matching, life insurance, paid time off including paid leave, and so much more. Learn more by visiting our Careers Page.
Member Facing Position:
No- Not Member Facing Position
Location:
St. Louis, MO
Time Type:
Full time
Lumeris and its partners are committed to protecting our high-risk members & prospects when conducting business in-person. All personnel who interact with at-risk members or prospects are required to have completed, at a minimum, the initial series of an approved COVID-19 vaccine. If this role has been identified as member-facing, proof of vaccination will be required as a condition of employment.