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Position Details

  • Position: Compliance Analyst
  • Employment Type: Full-Time
  • Location: Allentown PA

Ideal Concepts, Inc. is looking for a Compliance Analyst to assist with the development and implementation of the Company’s Compliance Program. The Compliance Analyst position is key to ensuring our company’s compliance with company policies, carrier requirements, CMS regulations, and all other applicable federal and state laws.  In accordance with our Compliance Program, the Compliance Analyst will help investigate reported compliance concerns, provide findings and feedback to Compliance Department leadership and sales management, and facilitate the remediation of reported compliance concerns. 

The Compliance Analyst will draft and review a variety of contracts and agreements, as well as review and provide feedback on various training and marketing materials.  The Compliance Analyst will also be responsible for conducting research into a wide variety of legal and regulatory topics, and generating responses to complaints and inquiries from clients, carriers, regulators, and other external stakeholders.

A strong candidate for this position must be highly detail-oriented with proven legal research and analytical skills, adaptable to change, driven to work independently with little need for supervision, and have the ability to complete work consistently with a high level of quality and accuracy within established timelines in a fast-paced environment. 

Responsibilities:

  • Conducting the intake, investigation, and remediation of reported compliance concerns.
  • Assisting with the drafting, reviewing, and redlining of various legal documents, including but not limited to, Business Associate Agreements, Non-Disclosure Agreements, Independent Contractor Agreements, and Master Service Agreements.
  • Acting as a regulatory resource to clarify, monitor, and research regulatory requirements, provides proactive compliance monitoring and assessments with regards to key initiatives and increasing compliance requirements, collaborates with other departments and business partners to manage corrective action processes when needed, and supports insurance carrier and regulatory audits.
  • Conducting legal research and analysis of findings related to existing and new legal, regulatory, and contractual requirements.
  • Drafting internal memorandum and summaries on research findings, and presenting said findings to management.
  • Assisting with the development, update, revision, and/or implementation of policies, procedures, and practices for the general compliance and operations.
  • Coordinating with other departments to gather information needed for regulatory reviews, validations, and audits.
  • Investigating, auditing, reviewing, and analyzing requirements of general compliance, Medicare, Medicaid, Affordable Care Act (ACA), Health Insurance Portability and Accountability Act (HIPAA), Gramm–Leach–Bliley Act (GLBA), Telephone Consumer Protection Act (TCPA), Federal Trade Commission (FTC) amended the Telemarketing Sales Rule (TSR), and other matters to ensure compliance with governmental regulations and internal policies.
  • Reviewing training and marketing materials for compliance with company policy and regulatory requirements.
  • Identifying areas for audit opportunities based on industry performance, regulatory focus areas and risk areas within the organization, which require strong critical thinking and analytical skills when performing various audits.
  • Establishing and maintaining open lines of communication, both internal and external, to effectively present department services, policies, procedures, and programs.
  • Producing accurate and concise work products that does not require revisions.
  • Working effectively within multidisciplinary teams.

Requirements:

  • A Bachelor’s degree with a minimum GPA of 3.0 in Healthcare Compliance, legal/paralegal, is required, JD strongly preferred.
  • Experience in compliance, audit, or other risk management working experience in health insurance industry, managed care and government programs, health insurance compliance programs, Medicare Advantage/Part D and Qualified Health Plan programs, or related fields a plus.

Skills:

  • The ability to read and interpret insurance laws, regulations, and policies is a must.
  • The successful candidate will possess strong organizational, coordination skills and interpersonal skills as well as the ability to gather and analyze data and generate reports.
  • Ability to perform at a high level of proficiency while working independently with minimal supervision.
  • Must have strong listening and comprehension skills.
  • Fast learner of complex topics with high memory retention and ability to think critically.
  • Excellent oral, written, and interpersonal communication skills.
  • Self-starter with strong work ethic, well-organized, and excellent time management to be able to multi-task, prioritize, and meet deadlines independently in a fast-paced environment.
  • Positive and self-motivated with the ability to change priorities on-demand.
  • Proven ability to handle multiple projects simultaneously and adjust to changes quickly while meeting deadlines.
  • Demonstrated ability to work well individually and in a team environment.
  • Skilled at research and problem solving.
  • Proficient in Microsoft Windows, Microsoft Excel, Microsoft Word, Microsoft PowerPoint, and Internet knowledge.
  • Experience with LexisNexis strongly preferred.

Benefits:

  • Company pays 100% of the employee's weekly premium for major medical, dental, vision, and life insurance (family members may be added for an additional cost).
  • Employee 401k Plan.
  • Generous PTO policy.
  • 8 paid pre-determined holidays.
  • Technology-focused, fast-paced working environment.
  • Professional team atmosphere with motivated, career-driven professionals as co-workers.
  • Expansion and growth with one of the top health insurance marketing companies in the nation.

This is normally an on-site position, located in Allentown, PA. In light of COVID-19 (Coronavirus), we have made temporary arrangements for our staff to be able to work remotely. We will soon return to our offices, at which time, remote work will not be an option for this position.

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