Job Description

Compliance Research And Policy Analyst

The Compliance Research And Policy Analyst is a vital contributor within the Compliance Department, dedicated to ensuring Central Health's healthcare delivery and operational programs strictly adhere to all applicable laws, regulations, policies, and ethical standards. This role is pivotal in conducting in-depth policy research and comprehensive regulatory analyses to inform internal compliance strategies and operational guidance. The Analyst will translate complex regulatory changes into actionable internal policies and procedures, proactively monitor legislative developments, and significantly contribute to compliance reporting, risk assessments, and continuous improvement initiatives across both clinical and administrative functions.

Responsibilities

Essential Functions:

• Conducts in-depth analysis of federal, state, and local laws, regulations, and guidance pertaining to third party payors, HIPAA, managed care, and broader healthcare delivery systems.
• Supports organizational goals and objectives aimed at optimizing the health of the covered population, reducing health disparities, and improving clinical outcomes, health equity, patient experience, and cost-effectiveness across the entire delivery system.
• Translates complex regulatory requirements into clear, concise, and actionable internal policies and procedures.
• Drafts and meticulously revises compliance-related policies and procedures, ensuring ongoing alignment with current and developing regulations, industry best practices, and organizational priorities.
• Coordinates systematic policy reviews across various departments and maintains rigorous policy version control to ensure accuracy and consistency.
• Actively tracks and analyzes legislative and regulatory changes relevant to the organization's operations and strategic objectives.
• Assists in comprehensive compliance risk assessments and the subsequent development of robust mitigation strategies.
• Contributes to the preparation of internal and external compliance reports, including those for executive leadership and the Board Of Managers.
• Serves as a key policy advisor to internal departments (e.g., operations, clinical delivery, quality, and Joint Technology) on complex compliance-related issues and regulatory interpretations.
• Participates actively in cross-functional teams to support the effective implementation of compliance initiatives throughout the healthcare delivery system.
• Develops comprehensive summaries, briefs, and compelling presentations on complex policy and regulatory topics for diverse audiences, including staff, leadership, and community stakeholders.
• Assists in the development of impactful compliance training materials related to policy updates and emerging regulatory trends.
• Performs other duties as assigned.

Knowledge, Skills and Abilities:

• Ability to thrive in a complex and dynamic work environment with multidisciplinary, cross-functional teams and matrixed team structures
• Ability to prioritize multiple complex projects with varying deadlines and limited resources
• Deep understanding of healthcare regulations and public health policy, including HIPAA, Medicaid, CMS regulations, OIG guidance, and Texas state health laws
• Working knowledge of the legislative and regulatory process at both state and federal levels
• Ability to assess and support the rapid development of health care services
• Ability to effectively understand basic legal considerations related to service delivery and the practice of medicine
• Ability to apply critical thinking to generate and assess potential solutions and to anticipate client needs in advance
• Ability to manage competing objectives in an ambiguous, fast-moving environment to achieve results
• Knowledge of data, measurement concepts, measurement tools and systems used to monitor and report clinical quality metrics, healthcare safety and other healthcare outcomes
• Ensure compliance with data confidentiality and security laws, regulations, policies and standard operating procedures
• Exceptional interpersonal skills with ability to interface effectively internally and externally with a wide range of people including colleagues, physicians, health care executives, community organizations and assigned staff
• Strong writing and editing skills for technical, legal, and policy documents
• Strong attention to detail and accuracy
• Ability to communicate complex ideas clearly and effectively through both writing and speaking
• Demonstrated ability to perform complex operations in Microsoft Office Suite
• Supports and models the vision, mission and values of Central Health
• Responds in timely manner to the needs and concerns of colleagues, providers, staff and other stakeholders
• Adheres to all local, state and federal laws and regulations and Central Health policies

Qualifications

Minimum Education:

• Bachelor's degree in Public Health, Public Policy, Healthcare Administration, Political Science, or a related field

Minimum Experience:

• 4 years Experience in policy research, compliance, or a healthcare regulatory role

Job Tags

Similar Jobs