Healthcare Regulatory Strategy – Operations

November 3

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Stedi

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Healthcare Insurance • API • Fintech

Stedi is an API-first clearinghouse that facilitates the automation of healthcare transactions, such as real-time eligibility checks and claims processing. The platform offers modern, developer-friendly JSON-based APIs, enabling fast integration and interaction with over 7,000 payers, thus supporting a broad payer network. Stedi is designed with reliability in mind, featuring multi-region, highly-available APIs with automatic failover for increased uptime. The company prioritizes security, with HIPAA and SOC 2 compliance, role-based access, and multi-factor authentication. Stedi provides robust support, including hands-on engineering assistance and dedicated communication channels, ensuring fast onboarding and efficient transaction management for health tech companies.

51 - 200 employees

⚕️ Healthcare Insurance

🔌 API

💳 Fintech

📋 Description

• Build and maintain a commanding knowledge of CAQH CORE operating rules, 45 CFR Part 162 transaction standards, CMS guidance letters, and related materials to build Stedi's regulatory fact base that will inform our payer connectivity and product surface area. • Partner with Legal, Operations, and Executive teams to interpret federal and state-level guidance and translate it into actionable strategies that remove blockers to connectivity. • Identify, analyze, and resolve payer-side regulatory challenges – including nonconformance, exclusivity agreements, and data submission policies – to accelerate network growth. • Draft outreach citing specific, relevant regulation that compels action while maintaining excellent relationships with payers and a stellar reputation in the industry. • Work directly with world-class external counsel when necessary, while recognizing that over 95% of situations should be resolved without outside help. • Maintain a system of record for payer communication, regulatory milestones, and escalations – ensuring consistency, traceability, and accountability. • Represent Stedi in discussions with payers, clearinghouses, and regulators, and continue to establish Stedi as a trusted, compliant, and forward-thinking network partner.

🎯 Requirements

• You are a regulatory expert with deep fluency in HIPAA standard transactions (837, 835, 270/271, EFT, etc.) and a working understanding of the operational realities behind them. • Law degree strongly preferred. If you don't have a JD, you must have equivalent regulatory interpretation experience and negotiation expertise – for example, former clearinghouse compliance director, PE firm healthcare advisor, or policy lead at a health tech company. • You can sit down with a 60-page CMS guidance letter, extract the three sentences that matter for Stedi, and translate them into business strategy. • Someone who thrives in ambiguity, creates structure from chaos, and can independently design scalable processes from scratch. • You have the business acumen to blend legal rigor with strategic persuasion – knowing when to apply pressure, and when to collaborate. • You are relentless and resourceful. You follow up, escalate, and push until the job is done – and you do it with professionalism and integrity. • You can communicate clearly and confidently with payers, regulators, and executives, both in writing and in conversation. • You thrive on decoding complex technical and regulatory details, transforming them into actionable insights that expand our payer network and drive the business forward. • You move fast and operate with precision. You thrive in an environment where clarity, accountability, and urgency matter.

🏖️ Benefits

• Competitive salary • Remote work options