Job Description:
• Monitor and analyze federal and state laws and guidance affecting CareCentrix’s workers’ compensation, auto, and commercial program operations.
• Prepare and distribute clear written and verbal communications to impacted business areas.
• Provide cross‑functional support, guidance, and direction in developing policies, procedures, and operational changes required for legal and regulatory compliance.
• Partner with operational teams to implement these changes effectively.
• Secure and maintain all required operational licenses.
• Support the onboarding and implementation of new CareCentrix workers’ compensation, auto, and commercial program clients.
• Identify and drive continuous improvement initiatives to enhance compliance tracking, trending, and reporting capabilities.
• Conduct internal audits as needed and identify opportunities for process improvement.
• Develop and deliver training programs to ensure teams fully understand compliance requirements.
Requirements:
• Bachelor’s degree preferred, or a minimum of 5 years of experience in a managed care setting working with laws impacting workers’ compensation, auto, and/or commercial health insurers and delegated entities.
• This includes experience with regulations governing utilization management, claims, network management, and credentialing.
• Demonstrated experience in regulatory affairs and/or the operations of HMOs, managed care organizations, or other insurers.
• Proficiency in Microsoft Office applications, including Excel, SharePoint, PowerPoint, and OneNote.
• Advanced legal research abilities; strong organizational and analytical skills; excellent written, verbal, and presentation communication skills; and exceptional attention to detail.
• Requires in-depth knowledge of state and federal workers’ compensation, auto, and/or commercial managed healthcare regulations and guidelines.
Benefits:
• Medical
• Dental
• Vision
• 401(k) with company match
• HSA employer contributions
• Dependent Care FSA employer contribution
• Paid Time Off
• Personal/Sick Time
• Paid Parental Leave
• and more.