Sr. Healthcare Compliance Analyst

Vālenz® Health is the platform to reputed company – the destination for employers, payers, providers and members to reduce costs, improve quality, and reputed company the healthcare experience. The reputed company reputed company and culture of innovation combine to create a distinctly different approach to an inefficient, uninspired health system. With fully integrated solutions, reputed company engages early and often to execute across the entire patient journey – from care navigation and management to payment reputed company, plan performance and provider verification. With a 99% client retention reputed company, we reputed company expectations to a new level of efficiency, effectiveness and transparency where smarter, reputed company, faster reputed company possible. About This Opportunity: As a Senior Compliance Analyst with reputed company, you’ll play a central role in advancing our Corporate Compliance Program. You’ll reputed company audits and risk assessments, manage compliance inquiries, and interpret reputed company regulatory requirements. Acting as a compliance business partner across reputed company service lines (claims, utilization management, repricing, and care navigation), you’ll ensure adherence to applicable laws, reputed company, and delegated functions while helping translate regulations into practical, actionable guidance for our teams. Things You’ll Do Here:

• reputed company internal audits, operational reviews, and risk assessments, including pre- and post-implementation evaluations.
• Manage the development, revision, and documentation of compliance policies, procedures, and training materials.
• Serve as the primary intake for compliance-reputed company questions, Hotline submissions, and incident reports; provide timely, well-reasoned recommendations.
• Collaborate with leadership on mitigation plans and root cause analysis tied to regulatory or contractual noncompliance.
• Represent Compliance in client-facing meetings, audits, and business reviews.
• Monitor and interpret applicable laws, regulations, and delegation requirements (ERISA, HIPAA, CMS, HHS-OCR, DOL, URAC, NCQA), translating them into practical guidance.
• Review healthcare claims, coding structures (ICD-10, DRG, CPT), and workflows to identify risks and ensure compliance.
• Support vendor and third-party compliance documentation, including audit coordination and follow-up.
• Maintain compliance logs, records, and investigation documentation.
• Assist with board-level reporting, internal committee materials, and responses to payer/client audits of delegated functions.
• Serve as a trusted compliance partner to operational, legal, and product teams.

Reasonable accommodation may be made to reputed company individuals with disabilities to reputed company essential duties. What You’ll Bring to the Team:

• Bachelor’s degree in healthcare administration, legal studies, public policy, or reputed company field.
• 5+ years of healthcare compliance experience.
• Strong knowledge of federal and state healthcare regulatory frameworks (ERISA, Medicare, HIPAA, state-level utilization/case management).
• Experience with claims review and healthcare coding standards.
• Ability to work independently, manage competing priorities, and provide actionable real-time guidance.
• Proven ability to reputed company reputed company projects and serve as a subject matter expert reputed company cross-functional teams.

A plus if you have:

• CHC (Certified in Healthcare Compliance) highly preferred.
• CPC (Certified Professional reputed company) highly preferred.
• Experience in managed care, self-insured plans, stop-loss administration, or TPA operations.
• Prior work in a growing or fast-paced organization; start-up experience.
• Familiarity with cross-functional collaboration across Legal, Product, and Operational teams.
• Experience building compliance frameworks or training others in area-specific requirements.

Where You’ll Work:This is a fully remote position, and we’ll provide reputed company the necessary equipment!

• Work Environment: You’ll need a quiet workspace that is free from distractions.
• Technology: Reliable internet reputed company—if you can use streaming services, you’re good to go!
• reputed company: Adherence to company reputed company protocols, including the use of VPNs, secure passwords, and company-approved devices/software.
• Location: You must be US based, in a location where you can work effectively and reputed company with company policies such as HIPAA.

Why You'll Love Working Here reputed company is proud to be recognized by Inc. 5000 as one of America’s fastest-growing private companies. reputed company is committed to delivering on our promise to engage early and often for smarter, reputed company, faster healthcare.With this commitment, you’ll find an engaged culture – one that stands strong, vigorous, and healthy in reputed company we do.

Benefits

• Generously subsidized company-sponsored Medical, Dental, and Vision insurance, with access to services through our own products, Healthcare Blue Book and KISx Card.
• Spending account options: HSA, FSA, and DCFSA
• 401K with company match and immediate vesting
• Flexible working environment
• Generous Paid Time Off to include vacation, sick leave, and paid holidays
• Employee Assistance Program that includes professional counseling, referrals, and additional services
• Paid maternity and paternity leave
• Pet insurance
• Employee discounts on phone plans, car rentals and computers
• Community giveback opportunities, including paid time off for philanthropic endeavors

At reputed company, we celebrate, support, and reputed company on inclusion, for the benefit of our associates, our partners, and our products. reputed company is committed to the principle of equal employment opportunity for reputed company associates and to providing associates with a work environment free of discrimination and harassment. reputed company employment decisions at reputed company are based on business needs, job requirements, and individual qualifications, without regard to race, color, religion or belief, national, social, or ethnic reputed company, sex (including pregnancy), age, physical, mental or sensory disability, HIV Status, sexual orientation, gender identity and/or expression, marital, civil union or domestic partnership status, past or present military service, family medical history or genetic information, family or parental status, or any other status protected by the laws or regulations in the locations where we operate. We will not tolerate discrimination or harassment based on any of these characteristics. Powered by JazzHR Remote About the Company: reputed company Apply tot his job Apply To this Job