Regulatory Reporting Analyst

Job DetailsKey ResponsibilitiesMonitor and track all state regulatory requirements received from ProCare's legal teamPrepare and submit ProCare's annual CAA (Consolidated Appropriations Act) RxDC reporting to CMSLead the yearly development and submission of ProCare's URAC accreditation reporting, including building and automating the required annual accreditation reports and supporting data validations and follow-up requests from auditorsBuild and maintain the SQL queries, data extracts, and reports needed to satisfy each regulatory filing, pulling from claims, eligibility, and pricing data sourcesCreate and manage a master calendar of all state and federal filing deadlines and ensure on-time, accurate submissionValidate report accuracy and completeness prior to submission, including reconciliation against source systemsMaintain documentation of report logic, data sources, and submission processes for each regulatory requirementServe as the primary contact for regulator inquiries, audits, and data requests related to PBM reportingPartner with Legal, Rebates, and Finance teams to interpret new regulations and translate them into reporting specificationsIdentify opportunities to automate and streamline recurring regulatory reportsTrack and report on the status of all open regulatory reporting obligations to leadershipRequired QualificationsBachelor's degree in a related field (Healthcare Administration, Business, Finance, Information Systems, or similar), or equivalent work experience2+ years of experience in regulatory reporting, compliance, or data analysis, ideally within a PBM, health plan, or healthcare payer environmentSQL proficiency required — able to independently write and troubleshoot complex queries (joins, aggregations, subqueries) against large claims and eligibility datasetsWorking knowledge of PBM operations and terminology (claims adjudication, eligibility, formulary, rebates)Strong attention to detail and ability to manage multiple concurrent deadlines across different states and agenciesExcellent written and verbal communication skills, including the ability to explain regulatory and technical concepts to non-technical stakeholdersProficiency with Excel for data validation and ad hoc analysisPreferred QualificationsDirect experience with PBM state licensing, NCPDP, Medicaid MCO, or CMS Part D reporting requirementsFamiliarity with data warehouse and BI tools (e.g., QlikView, Power BI, Tableau) used to build and automate regulatory reportsExperience working directly with state regulators or CMS on audits, examinations, or data requestsParalegal, compliance, or health law backgroundExperience with Python or another scripting language for data automationEqual Opportunity Employer This employer is required to notify all applicants of their rights pursuant to federal employment laws. For further information, please review the Know Your Rights notice from the Department of Labor.