Appeals & Grievances Regulatory Analyst
$78.7k - $134.9kMedica
Medica is a nonprofit health plan with more than a million members that serves communities in Minnesota, Nebraska, Wisconsin, Missouri, and beyond. We deliver personalized health care experiences and partner closely with providers to ensure members are genuinely cared for. We're a team that owns our work with accountability, makes data-driven decisions, embraces continuous learning, and celebrates collaboration - because success is a team sport. It's our mission to be there in the moments that matter most for our members and employees. Join us in creating a community of connected care, where coordinated, quality service is the norm and every member feels valued. Oversees and implements activities to support Medica's business units and to ensure adherence with federal, state and local regulations and/or contractual requirements. Works with internal teams and/or regulatory agencies and vendors as needed to ensure policies and procedures are compliant, requirements are communicated, and proper auditing, reporting, and/or monitoring is completed. Performs other duties as assigned. Key Accountabilities Oversees and implements activities that support Medica's business units Ensures adherence to federal, state, and local regulations, as well as contractual requirements Collaborates with internal teams, regulatory agencies, and vendors as needed Ensures policies and procedures remain compliant Communicates regulatory requirements across teams Conducts or oversees auditing, reporting, and monitoring activities Leads regulatory compliance efforts across operations Supports implementation of compliant processes and procedures Ensures alignment between business operations and regulatory expectations Required Qualifications Bachelor's degree or equivalent experience in related field 7+ years of work experience beyond degree This position is an Office role, which requires an employee to work onsite, on average, 3 days per week. We are open to candidates located near one of the following office locations: Minnetonka, MN, Madison, WI, St. Louis, MO, or Omaha, NE. The full salary grade for this position is $78,700 - $134,900. While the full salary grade is provided, the typical hiring salary range for this role is expected to be between $78,700 - $118,020. Annual salary range placement will depend on a variety of factors including, but not limited to, education, work experience, applicable certifications and/or licensure, the position's scope and responsibility, internal pay equity and external market salary data. In addition to compensation, Medica offers a generous total rewards package that includes competitive medical, dental, vision, PTO, Holidays, paid volunteer time off, 401K contributions, caregiver services and many other benefits to support our employees. The compensation and benefits information is provided as of the date of this posting. Medica's compensation and benefits are subject to change at any time, with or without notice, subject to applicable law. Eligibility to work in the US Medica does not offer work visa sponsorship for this role. All candidates must be legally authorized to work in the United States at the time of application. Employment is contingent on verification of identity and eligibility to work in the United States. We are an Equal Opportunity employer, where all qualified candidates receive consideration for employment indiscriminate of race, religion, ethnicity, national origin, citizenship, gender, gender identity, sexual orientation, age, veteran status, disability, genetic information, or any other protected characteristic. Equal Opportunity Employer/Protected Veterans/Individuals with Disabilities This employer is required to notify all applicants of their rights pursuant to federal employment laws. For further information, please review Know Your Rights notice from the Department of Labor. #J-18808-Ljbffr Medica
- ...Grievance And Appeals Analyst I Grievance/Appeals Analyst I Shift: MondayFriday with one Saturday per month Location: Virtual: This role... ...appeals requests from customer types (i.e. member, provider, regulatory and third party) and multiple products (i.e. HMO, POS,...SuggestedFull timeWork at officeLocal areaShift work
$45.9k - $78.6k
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$37 - $47 per hour
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Overview As we continue to build our team in support of our vision to the be the world’s best and most trusted mobility company, Enterprise Fleet Management, a business line of Enterprise Mobility is excited to announce the opening of a Compliance Coordinator! The...Hourly payFull timeContract workWork at officeImmediate startRemote workWork from homeMonday to Friday$60k - $90k
...financial institutions operating in key markets and sectors. Norton Rose Fulbright is seeking an experienced Compliance (Conflicts) Analyst with conflicts review experience to join our US team. Compliance Analysts conduct conflict-of-interest research and analysis by...Full timeFor contractorsWork at officeRemote workWorldwideFlexible hours- Job Title Job Summary Should be proficient in excel with various formulas • Should be proficient in SQL. Should be able to write queries with minimal guidance • Should have experience in Visual basic. • Should have experience in working with clients to define requirements...
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Asteroom in St. Louis is looking for licensed Home Inspectors to join our team as Property Data Collectors. In this part-time contract role, you will use our advanced technology to gather essential property data and create virtual tours. Ideal candidates possess excellent...Hourly payContract workPart timeFlexible hours- Key Responsibilities Author, compile, review, and submit regulatory documents in eCTD format, including NDAs, ANDAs, DMFs, and post-approval submissions. Support FDA regulatory activities for marketed pharmaceutical products. Evaluate CMC regulatory impact of manufacturing...Work at office
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Twin Pines is seeking a Compliance Coordinator to support affordable housing programs. This role includes file preparation, documentation tracking, and compliance operations to ensure files are complete and audit-ready. The ideal candidate is detail-oriented, eager to ...Full time- Dormont Manufacturing Co in St. Louis is looking for a Compliance Analyst to support its ethics and compliance program. The role involves monitoring business operations for compliance, supporting compliance assessments, and assisting in investigations under compliance leadership...
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$16 per hour
...domestic equity markets. We are seeking a detail-oriented Compliance Analyst Intern to support our compliance function through data-driven... ...including client guideline testing, trade surveillance, regulatory support and testing of the firm's compliance policies and procedures...Hourly paySummer workInternshipWork at office$107k - $160k
...of Banking as a Service, Chief Compliance Officer and executive management on appropriate measures to be taken to ensure ongoing regulatory compliance as the Company responds to changing market conditions. This is a leadership role that will also provide compliance expertise...Full timeContract workTemporary workWork at officeLocal area
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