The specialist will manage Medicaid credentialing, provider enrollment, and ensure adherence to healthcare regulatory frameworks like HIPAA and FWA. They will also oversee corporate state registrations, contract management, and provide regulatory guidance to the executive team.
Compliance and Regulatory Specialist
Department: Compliance
Employment Type: Full Time
Location: United States
Reporting To: Chief of Staff
Compensation: $70,000 - $100,000 / year
Description
This is a full-time remote role for a Compliance and Regulatory Specialist. Reporting directly to the Chief of Staff, you will be our internal compass for Medicaid regulatory frameworks, managing MCO credentialing, corporate state registrations, and day-to-day compliance operations.
Key Responsibilities
Medicaid Credentialing & Enrollment: Lead the end-to-end provider enrollment and credentialing process with state Medicaid agencies and Medicaid Managed Care Organizations (MCOs). Ensure all documentation is accurate, submitted on time, and tracked through approval.
Healthcare Compliance & Policy: Enforce adherence to Medicaid regulatory requirements, including Fraud, Waste, and Abuse (FWA) protocols, and HIPAA. Assist the Chief of Staff in drafting, updating, and auditing internal compliance policies to align with shifting state rules.
State Registrations & Filings: Manage and maintain corporate state registrations, annual reports, and foreign qualifications across all states where RxDiet operates.
Document & Contract Management: Draft, review, and organize standard vendor agreements, Business Associate Agreements (BAAs), and non-disclosure agreements. Manage the repository of all payer contracts and ensure terms align with regulatory requirements.
Cross-Functional Support: Act as a liaison between external legal counsel, state health departments, operations, and the executive team to gather required information for Medicaid audits, legal inquiries, and new market expansions.
Medicaid Regulatory Affairs: Monitor, research, and interpret state and federal Medicaid regulations, CMS guidelines, and emerging policies. Translate complex regulatory text into clear, actionable guidance for leadership.
Skills, Knowledge and Expertise
Experience: 3+ years of experience as a paralegal, compliance specialist, or regulatory coordinator, with a heavy emphasis on Medicaid policy and healthcare operations.
Medicaid Regulatory Knowledge: Proven ability to read, comprehend, and operationalize complex legal and regulatory text from state Medicaid provider manuals, CMS updates, and MCO contracts.
Credentialing Expertise: Deep understanding of state Medicaid provider enrollment portals, MCO credentialing processes, and platforms like CAQH.
Attention to Detail: Exceptional organizational skills and a meticulous approach to navigating bureaucratic state portals, managing strict deadlines, and maintaining audit-ready files.
Autonomy: Proven ability to thrive in a remote, fast-paced startup environment. You are a self-starter who can take a complex state enrollment or regulatory research project from start to finish with minimal micromanagement.
Communication: Strong written and verbal communication skills, with a talent for distilling dense regulatory jargon into plain English for the RxDiet team.
Benefits
Competitive salary (OTE up to $200,000 per year) and equity options.
100% company-covered medical, dental, and vision insurance
401K
Flexible PTO and fully remote work environment.
Home Office Stipend
Monthly Wifi Stipend
12 Weeks of medically tailored groceries for the whole family
The opportunity to make a tangible impact at a mission-driven company at the forefront of the "food as medicine" movement.
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