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- Accountabilities: Manage the preparation, validation, and timely submission of recurring client and government compliance reports, ensuring accuracy and adherence to applicable regulatory requirements. Take ownership of assigned reporting…
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Accountabilities: Manage the preparation, validation, and timely submission of recurring client and government compliance reports, ensuring accuracy and adherence to applicable regulatory requirements. Take ownership of assigned reporting activities from data collection and processing through quality assurance, final review, and submission tracking. Learn and apply relevant regulatory frameworks, including the Code of Federal Regulations (CFR), Managed Care Organization (MCO) agreements, and state Medicaid handbooks. Perform prescribed quality assurance checks to identify data discrepancies, broken formulas, unexplained variances, and reporting inconsistencies, escalating potential risks before they affect submission deadlines. Collaborate with Data Analytics teams to translate reporting requirements, data issues, and process gaps into clear, actionable technical requests and development tickets. Serve as a key connection between compliance reporting needs and technical resources, helping prioritize requests and facilitate effective communication across departments. Identify opportunities to improve existing reporting workflows, reduce manual processes, and strengthen operational efficiency and regulatory compliance. Lead and contribute to reporting automation initiatives in partnership with Data Analytics, Product, and Operations teams. Document reporting procedures, workflows, field mappings, regulatory research, and key decisions to establish consistent, repeatable, and audit-ready processes. Maintain accurate reporting records and submission documentation to support internal reviews, regulatory requirements, and compliance audits. Establish priorities, manage reporting schedules, and coordinate deadlines across multiple recurring reporting responsibilities. Build strong working relationships with internal stakeholders to support reporting improvements and ensure alignment between regulatory obligations and operational capabilities. Contribute to the development and stabilization of the compliance reporting function, helping establish scalable processes that support future business growth. Requirements: At least 2 years of professional experience as a Reporting Analyst, Data Analyst, Business Analyst, or in a similar data-focused position involving report development, dataset analysis, and data validation. At least 1 year of experience within the healthcare industry, healthcare regulatory research, or health plan operations, with exposure to regulatory analysis and compliance reporting. Intermediate to advanced Microsoft Excel proficiency, including formulas, VLOOKUPs, pivot tables, data validation, and data concatenation. Strong data entry accuracy and experience applying structured quality assurance procedures to identify and resolve reporting discrepancies. Working knowledge of SQL, data-query languages, or Python scripting, with the ability to understand technical data flows and communicate effectively with Data Analytics teams. Familiarity with data visualization and reporting platforms such as Amazon QuickSight, Tableau, or Power BI. Strong analytical thinking and problem-solving abilities, with the capacity to independently investigate issues, interpret regulatory requirements, and assess their impact on operational processes. Ability to manage multiple reporting deadlines simultaneously while maintaining accurate documentation and audit-ready records. Strong organizational skills, attention to detail, and the ability to identify process gaps and recommend practical improvements. Proactive and ownership-oriented mindset, with an interest in developing beyond routine reporting tasks into process optimization, automation, and strategic initiatives. Highly Preferred Qualifications: Previous experience with Medicare and Medicaid reporting, including familiarity with the Code of Federal Regulations (CFR), MCO agreements, and state Medicaid handbooks. Understanding of health plan operations, including claims processing, utilization management, prior authorizations, and call center operations. Strong project management and stakeholder engagement skills, with the ability to build trusted relationships and influence cross-functional teams collaboratively. Familiarity with project management and collaboration tools such as Asana, Jira, or similar platforms. Willingness and ability to travel approximately 2–4 times per year for company or team meetings. Must be legally authorized to work in the United States. Ability to successfully complete a pre-employment background check. Benefits: Annual salary: Competitive base compensation ranging from $90,000 to $110,000, depending on experience, specialized skills, qualifications, internal equity, and market conditions. Employment type: Full-time, salaried exempt position. Work arrangement: Fully remote opportunity based in the United States. Professional development: Opportunity to develop expertise in healthcare compliance, Medicare and Medicaid reporting, data analytics, and regulatory frameworks. Career growth: Exposure to strategic reporting initiatives, process optimization, and automation projects within a growing compliance function. Cross-functional collaboration: Work closely with Data Analytics, Product, and Operations teams on impactful business and compliance initiatives. Travel opportunities: Approximately 2–4 trips per year for company or team offsites. Meaningful impact: Contribute to stronger healthcare reporting processes and support reliable access to care through improved compliance and operational performance. How Jobgether works: We use an AI-powered matching process to ensure your application is reviewed quickly, objectively, and fairly against the role's core requirements. Our system identifies the top-fitting candidates, and this shortlist is then shared directly with the hiring company. The final decision and next steps (interviews, assessments) are managed by their internal team. We appreciate your interest and wish you the best! Why Apply Through Jobgether? Data Privacy Notice: By submitting your application, you acknowledge that Jobgether will process your personal data to evaluate your candidacy and share relevant information with the hiring employer. This processing is based on legitimate interest and pre-contractual measures under applicable data protection laws (including GDPR). You may exercise your rights (access, rectification, erasure, objection) at any time. #LI-CL1
- LOCATION
- Remote · US, United States
- WORK MODE
- Remote
- JOB TYPE
- Full-time
- POSTED
- Nov 9, 2026
Source: Jobgether Careers