Analyst III – Regulatory Compliance, Government Programs

May 11, 2026

Job Description:

Monitor and analyze federal and state laws and guidance impacting CareCentrix’s government programs (e.g., Medicare Advantage and Managed Medicaid) and communicate updates clearly through written and verbal channels to relevant business areas.
Provide cross-functional guidance in developing policies, procedures, and operational changes to ensure compliance with legal requirements, and support implementation across operational teams.
Coordinate and support compliance audits, including Medicare Part C program audits, reporting, and managed Medicaid audits, ensuring timely and accurate responses.
Assist with onboarding new government program customers, ensuring compliance requirements are integrated into operational processes.
Drive continuous improvement initiatives to enhance compliance tracking, trending, and reporting tools for greater efficiency and accuracy.
Conduct internal audits to assess compliance effectiveness and identify opportunities for improvement.
Design and deliver training programs that promote a clear understanding of compliance requirements across the organization.

Requirements:

Bachelor’s degree preferred or a minimum of 5 years’ experience in a managed care setting.
Minimum 5 years’ experience working with managed care laws impacting Medicaid health insurers and delegated entities, including but not limited to, laws impacting utilization management, claims, network management, and credentialing.
Demonstrated experience in regulatory affairs and/or operations of HMOs, Managed Care Organization’s and/or government program health plans.
Proficiency in MS Office: Excel, SharePoint, PowerPoint, OneNote.
Advanced legal research skills, advanced organizational and analytical skills, excellent written and verbal communication/presentation skills and attention to detail.
Strong knowledge of Medicare Advantage guidelines and state regulations applicable to Managed Medicaid.

Benefits:

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