Sr. Compliance Reporting Analyst (Healthcare)

TL;DR

Sr. Compliance Reporting Analyst (Healthcare): Performing compliance reporting reviews and audits to ensure adherence to federal and state regulations with an accent on NCQA, URAC, and client contractual requirements. Focus on auditing CMS data tables, managing ODAG submissions, and implementing quality improvement solutions.

Location: Remote (US), excluding AK, CA, CO, HI, NY, and WA

Salary: $75,000–$85,000 annually

Company

AI-powered clinical intelligence platform streamlining access to quality care through payer-provider collaboration and cost containment.

What you will do

• Conduct compliance reporting audits and reviews against federal, state, NCQA, and URAC regulations.
• Manage quality assurance for monthly ODAG universe submissions and coordinate root cause analysis for corrective actions.
• Collate and review quarterly Part C reports and other mandatory client submissions to ensure timely resolution of issues.
• Document audit findings, methodologies, and monitoring results in detailed work papers and memorandums.
• Analyze quality assurance and compliance data to prepare reports and design quality management solutions.
• Maintain an up-to-date knowledge of healthcare legislation and client service level agreements.

Requirements

• Must be based in the US, excluding AK, CA, CO, HI, NY, and WA.
• Minimum 2 years of experience in healthcare auditing, reporting, or operations.
• Certification in Healthcare Compliance (CHC).
• Associate’s or Bachelor’s degree preferred or equivalent work experience.
• Strong attention to detail and ability to thrive in a high-growth, rapidly changing health-tech environment.
• Effective cross-functional collaboration and interpersonal skills.

Culture & Benefits

• Fully remote opportunity with approximately 10% travel.
• Comprehensive medical, dental, vision, life, and disability insurance.
• 401K retirement plan with company match, flexible spending account (FSA), and health savings account (HSA).
• Flexible Time Off and company-paid holidays.
• Paid parental leave (up to 14 weeks) and pet insurance.

Hiring process

• Preliminary phone screening with Talent Acquisition.
• Interview with the Hiring Manager.
• Team interview and live technical exercise.
• Executive interview.