Loading jobs…
Loading jobs…
Capital Rx — Charlotte North Carolina
About Judi Health Judi Health is an enterprise health technology company providing a comprehensive suite of solutions for employers and health plans, including: Judi Rx , a public benefit corporation delivering full-service pharmacy benefit management (PBM) solutions to self-insured employers, Judi Health™ , which offers full-service health benefit management solutions to employers, TPAs, and health plans, and Judi® , the industry’s leading proprietary Enterprise Health Platform (EHP), which consolidates all claim administration-related workflows in one scalable, secure platform. S. and deploying the infrastructure we need for the care we deserve.
health .
Requirements
, including but not limited to monitoring CMS, ACA Marketplace and state guidance, supporting regulatory reporting
and supporting root cause analysis documentation.
Analyze proposed and final rules, guidance, and policy updates to determine applicability and business impact Summarize complex regulatory changes into clear, actionable insights for internal stakeholders Impact Analysis Implementation Conduct impact assessments across business functions including operations, compliance, network, clinical, and technology Partner with subject matter experts to define business
and implementation plans Support prioritization of regulatory initiatives based on risk, complexity, and deadlines Cross-Functional Coordination Facilitate working groups and stakeholder meetings to drive alignment on regulatory changes Track progress of implementation activities and ensure accountability across teams Act as a central liaison between legal, operations, and clinical leadership Documentation Reporting Maintain a centralized inventory of regulatory changes and implementation status Develop executive-level summaries, dashboards, and status reports Ensure documentation meets audit and compliance standards Compliance Risk Support Partner with Compliance to ensure adherence to regulatory
Identify risks, gaps, and dependencies associated with regulatory changes Support audit readiness and remediation efforts as needed Investigate regulatory-related defects and/or client compliance concerns and develop root cause analyses when necessary.
e.
Responsibilities
: Regulatory Monitoring Assessment Continuously monitor federal and state regulatory sources (e.g., CMS, state Medicaid agencies, HHS) for new or revised
Required Qualifications
: Bachelor’s degree in Healthcare Administration, Public Policy, Business, or related field 3+ years of relevant experience in healthcare, government programs, compliance, or regulatory analysis Thorough knowledge Medicare regulatory