Senior Regulatory Compliance and Revenue Cycle Analyst

🕒 July 21

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Catalight

WebsiteLinkedInAll Job Openings

501 - 1000 employees

🏥 Healthcare

📚 Education

🤝 B2B

Healthcare • Education • B2B

Catalight is a human-centered social enterprise that provides person-centered care, research, education, and technology-enabled solutions for individuals with intellectual and developmental disabilities and autism. Catalight operates a large care network (about 15,000 practitioners) delivering millions of annual service hours and leverages more than a decade of real-world clinical data to design treatment options, advanced care solutions for payers, and provider support. The organization also runs Catalight Academy (training and accredited courses), a postdoctoral training program, a foundation focused on addressing inequities, and advocacy efforts to improve access and outcomes for families and the healthcare system.

📋 Description

• Interpret and operationalize requirements across CMS, Medi-Cal (DHCS), DMHC, and other federal/state regulators. • Support compliance related to managed care contracts, delegated entities, and provider network operations. • Monitor and assess regulatory changes impacting health plans, reimbursement models, and care delivery. • Partner with legal, operations, and finance teams to ensure regulatory alignment in contracts and business practices. • Lead compliance oversight for billing, coding, documentation, and reimbursement practices. • Evaluate controls related to claims submission, denials management, and payment integrity. • Identify and mitigate risks related to overpayments, underpayments, and False Claims Act exposure. • Collaborate with Internal Audit and Enterprise Risk to align compliance monitoring with audit plans and enterprise risks.

🎯 Requirements

• 5+ years of experience in healthcare regulatory compliance, revenue cycle, or health plan operations. • Demonstrated expertise in billing, coding, reimbursement, and/or payment integrity. • Strong knowledge of government healthcare programs (e.g., Medicare, Medicaid/Medi-Cal). • Experience working in or with managed care organizations (MCOs), provider networks or delegated entities, healthcare services organizations, and third-party vendors. • Strong analytical and problem-solving skills with the ability to interpret and apply legal and regulatory requirements in multi-jurisdictional regulatory environments. • Excellent communication and interpersonal skills, with the ability to work effectively with internal and external stakeholders. • Highly organized, self-motivated, and detail-oriented. • Ability to manage sensitive information with discretion and professionalism.

🏖️ Benefits

• Health insurance • Individual development programs • Paid time off • Career advancement opportunities • Great team support