Senior Associate, Government Programs Compliance, Regulatory

🔥 0 minutes ago

🌽 Illinois, Massachusetts, +2 more states – Remote

🌽 Illinois – Remote 🍂 Massachusetts – Remote 🚗 Michigan – Remote 🔔 Pennsylvania – Remote

⏰ Full Time

🟠 Senior

🚔 Compliance

🦅 H1B Visa Sponsor

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👻 Ghost score 11%

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Ankura

WebsiteLinkedInAll Job Openings

1001 - 5000 employees

🎖️ Defense

🏗️ Construction

🏥 Healthcare

💰 Private Equity Round on 2021-11

Defense • Construction • Healthcare

Ankura is a leading global expert services and advisory firm, specializing in providing strategic advisory solutions across a multitude of industries. The company empowers clients by leveraging artificial intelligence to enhance decision-making, automate processes, and secure competitive advantages. Ankura is adept at handling crisis situations by offering strategic solutions that protect, create, and recover value for clients. The firm's multidisciplinary team collaborates to implement custom solutions that manage risk, compliance, and transformation challenges efficiently.

📋 Description

• Conduct research and analysis of federal and state regulatory requirements applicable to Medicare Advantage, Medicaid managed care, and Affordable Care Act programs • Interpret CMS guidance, state Medicaid contracts, regulatory communications, and other requirements to evaluate their impact on health plan operations • Review health plan policies, procedures, reports, data, operational documentation, and supporting materials to assess compliance • Analyze regulatory and operational issues, identify potential gaps or risks, and communicate findings to engagement leadership • Develop workpapers, findings, reports, presentations, and other client deliverables • Own defined project workstreams, coordinate assigned activities, monitor progress, and complete deliverables within established timelines • Work with Project Managers and engagement leaders to understand client concerns, define project objectives, and develop work plans • Apply structured problem-solving and critical-thinking skills to complex regulatory, compliance, and operational questions • Communicate project updates, emerging issues, and findings to engagement leadership • Collaborate with colleagues and client stakeholders • Review and provide guidance on work completed by junior team members, as appropriate • Support high-quality client deliverables 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 • Experience conducting regulatory research and translating complex requirements into practical operational considerations • Experience analyzing health plan data, policies, procedures, documentation, or operational processes • Strong analytical, critical-thinking, and problem-solving skills • Ability to develop clear, concise, and well-supported written analyses and client deliverables • Excellent written and verbal communication skills • Ability to manage multiple assignments, establish priorities, and meet deadlines in a client-service environment • Ability to work independently and as part of a collaborative engagement team • Proficiency in Microsoft Excel, Word, and PowerPoint • Willingness to travel based on client and engagement needs • Consulting or professional services experience preferred • Experience supporting or guiding junior team members preferred • Experience assessing health plan compliance with regulatory or contractual requirements • Experience with compliance audits, operational reviews, risk assessments, corrective action plans, or regulatory readiness activities • Familiarity with 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