Regulatory Case Manager
$72,800–$83,200 year
RemoteUnited States
Job Summary
Manage and oversee regulatory cases from initiation through resolution, ensuring timely and compliant outcomes. Review, analyze, and process regulatory submissions, appeals, and grievances in accordance with state and federal guidelines. Coordinate with internal departments, providers, and external agencies to gather documentation and facilitate case resolution. Monitor regulatory deadlines and maintain accurate case tracking logs and reporting systems. Prepare written correspondence, case summaries, and regulatory reports for internal and external stakeholders. Ensure adherence to DMHC, CMS, and other applicable healthcare regulatory requirements. Identify trends in regulatory cases and recommend process improvements to enhance compliance operations. This remote role supports a leading Independent Physician Association management company dedicated to delivering high-quality managed care services.
Required Qualifications
- 2+ years of experience in regulatory affairs, healthcare compliance, or case management
- Strong knowledge of healthcare regulations, including DMHC, CMS, or managed care guidelines
- Excellent written and verbal communication skills with the ability to draft clear, professional correspondence
- Proficiency in case management systems and Microsoft Office Suite
- Strong organizational skills with the ability to manage multiple deadlines simultaneously
- Detail-oriented, analytical mindset with a commitment to accuracy and compliance
- Bachelor's degree in Healthcare Administration, Business, or a related field preferred
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