Senior Associate, Government Programs Compliance, Regulatory

This is a fully remote position, open to applicants in Illinois, +3 more states.

📋 Description

• Conduct research and analyze federal and state regulatory requirements related to Medicare Advantage, Medicaid managed care, and Affordable Care Act programs.

• Interpret CMS guidance, state Medicaid contracts, regulatory communications, and other requirements to assess their impact on health plan operations.

• Review health plan policies, procedures, reports, data, operational documentation, and supporting materials to evaluate compliance.

• Analyze regulatory and operational challenges, identify potential gaps or risks, and communicate findings to engagement leadership.

• Develop workpapers, findings, reports, presentations, and other client deliverables.

• Manage defined project workstreams, coordinate assigned tasks, track progress, and ensure deliverables are completed within set timelines.

• Collaborate with Project Managers and engagement leaders to address client concerns, establish project objectives, and create work plans.

• Utilize structured problem-solving and critical-thinking skills to tackle complex regulatory, compliance, and operational questions.

• Provide project updates, highlight emerging issues, and share findings with engagement leadership.

• Collaborate with colleagues and client stakeholders effectively.

• Review and offer guidance on work completed by junior team members, as appropriate.

• Ensure high-quality client deliverables are produced within the desired timeframe.

• Contribute to practice development, internal knowledge sharing, tools, methodologies, and service offerings.

• Maintain confidentiality of client information and understand privileged and confidential communications.

⛳️ Requirements

• Bachelor’s degree from an accredited college or university.

• Approximately three to five years of relevant experience in health plan compliance, regulatory affairs, health plan operations, consulting, or a related field.

• Experience working with Medicare Advantage, Medicaid managed care, Affordable Care Act programs, or other government-sponsored health care programs.

• Working knowledge of CMS guidance, state Medicaid contractual requirements, and health plan operational processes.

• Proven experience conducting regulatory research and translating complex requirements into practical operational applications.

• Experience analyzing health plan data, policies, procedures, documentation, or operational processes.

• Strong analytical, critical-thinking, and problem-solving abilities.

• Capability to develop clear, concise, and well-supported written analyses and client deliverables.

• Excellent written and verbal communication skills.

• Ability to manage multiple assignments, set priorities, and meet deadlines in a client-service environment.

• Ability to work independently as well as part of a collaborative engagement team.

• Proficiency in Microsoft Excel, Word, and PowerPoint.

• Willingness to travel based on client and engagement requirements.

• Consulting or professional services experience preferred.

• Experience in supporting or guiding junior team members preferred.

• Experience in assessing health plan compliance with regulatory or contractual requirements.

• Familiarity with compliance audits, operational reviews, risk assessments, corrective action plans, or regulatory readiness activities.

• Understanding of multiple functional areas of health plan operations.

• Experience interacting directly with clients or senior internal stakeholders.

🏝️ Benefits

• Affirmative Action and Equal Opportunity Employer.

• Reasonable accommodation available for applicants with disabilities.