Behavioral Health Compliance Senior Consultant (Compliance Consultant Senior)

Behavioral Health Compliance Senior Consultant (Compliance Consultant Senior)

Location: This role requires associates to be in-office 1 - 2 days per week, fostering collaboration and connectivity, while providing flexibility to support productivity and work-life balance. This approach combines structured office engagement with the autonomy of virtual work, promoting a dynamic and adaptable workplace. Ideal candidates will be able to report to one of our Pulse Point locations in Indianapolis, IN or Grand Prairie, TX.

Please note that per our policy on hybrid/virtual work, candidates not within a reasonable commuting distance from the posting location(s) will not be considered for employment, unless an accommodation is granted as required by law.

The Behavioral Health Compliance Senior Consultant (Compliance Consultant Senior) supports compliance activities across behavioral health operations through regulatory research, audit coordination, issue management, compliance monitoring, and compliance consultation. The role partners with business stakeholders to identify compliance requirements, facilitate remediation activities, support audit readiness efforts, and promote adherence to applicable federal and state regulations, contractual obligations, accreditation standards, and organizational policies.

How you will make an impact:

• Provide senior level analytical support to projects, initiatives, regulatory audits or exams, internal audits, risk assessments.
• Apply critical thinking to formulate strategies and concepts that drive results, persuade and influence others, adapt to change, and manage conflict.
• Support behavioral health compliance by researching and interpreting federal and state regulations, contractual requirements, and accreditation standards, while providing compliance guidance and recommendations to business stakeholders.
• Coordinate compliance audits and reviews by managing regulatory examinations, delegated entity audits, document collection, evidence tracking, audit readiness, and remediation efforts.
• Manage compliance issues and risk mitigation by investigating compliance concerns, tracking corrective action plans, performing root cause analysis, monitoring issue resolution, and escalating significant risks as appropriate.
• Collaborate across the organization to support compliance initiatives, build stakeholder relationships, facilitate cross-functional projects, improve compliance processes, and contribute to organizational readiness and operational effectiveness.

Minimum Requirements:

Requires a BA/BS and minimum of 5 years health care, regulatory, ethics, compliance or privacy experience; or any combination of education and experience, which would provide an equivalent background. Travels to worksite and other locations as necessary.

Preferred Skills Capabilities and Experiences:

• Minimum of 4 years of experience in healthcare compliance, regulatory affairs, audit, risk management, or a related field highly preferred.
• Experience supporting behavioral health, managed care, Medicare, Medicaid, or health plan operations highly preferred.
• Experience conducting regulatory research, compliance analysis, and interpreting federal and state healthcare regulations highly preferred.
• Experience supporting audits, examinations, investigations, issue management, or remediation activities highly preferred.
• Knowledge of NCQA, CMS, Medicaid, Medicare, and behavioral health regulatory requirements highly preferred.
• Strong written, verbal, analytical, and organizational skills preferred.
• Ability to manage multiple priorities and deadlines in a fast-paced environment preferred.
• Proficiency with Microsoft Office applications, including Word, Excel, PowerPoint, and Teams preferred.
• Experience with ServiceNow or other compliance, audit, or issue management systems preferred.
• Certified in Healthcare Compliance (CHC) or other relevant compliance certification highly preferred.

Job Level: Non-Management Exempt