Manager, Regulatory Compliance

Overview

Overview:  

HealthEdge is seeking a Manager, Regulatory Compliance to lead a team of regulatory professionals supporting HealthEdge Source™, HealthEdge’s reference data and pricing transparency platform. The Manager, Regulatory Compliance will lead a team of regulatory professionals responsible for monitoring, interpreting, and operationalizing federal and state regulatory requirements to align our products with regulatory changes impacting commercial, Medicare, and Medicaid lines of business. The Manager will coach, develop, and lead a team of claims pricing and editing subject matter experts, ensuring high-quality regulatory outputs, strong team engagement, and operational excellence. 

The ideal candidate is a proven people manager who brings healthcare regulatory or reference data knowledge sufficient to guide the team’s work – someone who leads through others, builds capability, and creates accountability structures that allow the team to deliver consistently against a complex and evolving regulatory landscape. 

Your Impact 

As the Manager, Regulatory Compliance for HealthEdge Source™, you will: 

• Build and sustain a high-performing team of regulatory and reference data SMEs through active coaching, clear expectations, and ongoing feedback. 

• Manage workload distribution, prioritization, and delivery across the team to meet regulatory milestones and Source product release commitments. 

• Serve as an escalation point for Source-related regulatory issues, guiding the team through complex interpretation and resolution. 

• Partner with Product, Engineering, and Client Success stakeholders to ensure regulatory requirements are clearly understood and operationalized in Source. 

What you will do:  

People Leadership & Team Management 

• Lead, supervise, and develop a team of regulatory compliance professionals with expertise in claims pricing, reference data, and healthcare transparency requirements. 

• Conduct regular one-on-ones, performance reviews, and career development conversations. 

• Build a team culture grounded in accountability, intellectual rigor, collaboration, and continuous improvement. 

• Manage workload planning, capacity, and coverage to ensure consistent delivery against regulatory timelines and data release cycles. 

• Drive onboarding and skill development for new and existing team members as Source’s regulatory scope evolves. 

Source Regulatory Operations 

• Oversee the team’s monitoring, interpretation, and documentation of federal and state regulatory requirements impacting pricing, reference data and editing. 

• Ensure regulatory deliverables - system requirement specifications, and client-facing materials – are accurate, timely, and meet quality standards. 

• Manage the team’s review and disposition of regulatory changes relevant to Source across commercial, Medicare Advantage, and Medicaid lines of business. 

• Oversee escalation management and resolution of complex regulatory issues affecting Source customers or product functionality. 

Cross-Functional Partnership 

• Partner with Source Product and Engineering to ensure regulatory requirements are incorporated into roadmap planning and sprint execution. 

• Collaborate with Client Success and Implementation teams to support health plan client inquiries related to Source regulatory content. 

• Represent the team’s work in cross-functional meetings, regulatory forums, and client-facing engagements as needed. 

• Coordinate on enterprise regulatory monitoring and cross-product impact assessments where Source data intersects with other HealthEdge platforms. 

What you bring:  

Education & Experience 

• Bachelor's degree or equivalent combination of education and experience. 

• 8+ years of experience in healthcare regulatory compliance, healthcare operations, managed care, or a related field. 

• 5+ years of progressive people leadership experience, including leading teams of highly specialized professionals. 

• Demonstrated success building team capability, managing performance, and developing staff in a technical or compliance environment. 

• Experience working within or in support of a healthcare technology or managed care organization. 

Knowledge, Skills & Abilities 

• Working knowledge of claims pricing, editing and reference data concepts 

• Familiarity with Transparency in Coverage requirements, including MRF obligations, schema versioning, and in-network/out-of-network file content standards. 

• Ability to translate regulatory requirements into clear, actionable guidance for team members and cross-functional partners. 

• Exceptional people management skills: coaching, feedback, performance management, and team building. 

• Strong organizational and prioritization skills; comfortable managing multiple workstreams and release deadlines. 

• Clear written and verbal communication; able to summarize complex regulatory content for varied audiences. 

Preferred Qualifications 

• Experience supporting healthcare SaaS products or healthcare technology platforms. 

• Familiarity with HealthEdge Source™ or comparable claims pricing, editing, reference data and pricing transparency platforms. 

• Knowledge of CMS regulations, NCQA accreditation standards, interoperability requirements, HL7 FHIR, TEFCA, HIPAA, and related healthcare compliance frameworks. 

• Experience supporting core administration platforms, care management solutions, or digital health technologies. 

• Familiarity with Agile product development methodologies and regulatory-driven release management. 

• Experience leading organizational transformation, functional redesign, or large-scale compliance initiatives. 

Geographic Responsibility:  Remote, US

Type of Employment: Full-time, permanent 

FLSA Classification (USA Only): Exempt  

Work Environment: The physical demands described here are representative of those that must be met by an employee to successfully perform the essential functions of this job:  

• The employee is occasionally required to move around the office. Specific vision abilities required by this job include close vision, color vision, peripheral vision, depth perception, and ability to adjust focus.  

• Work across multiple time zones in a hybrid or remote work environment. 

• Long periods of time sitting and/or standing in front of a computer using video technology. 

• May require travel dependent on company needs. 

The above statements are intended to describe the general nature and level of the job being performed by the individual(s) assigned to this position. They are not intended to be an exhaustive list of all duties, responsibilities, and skills required. HealthEdge reserves the right to modify, add, or remove duties and to assign other duties as necessary. In addition, reasonable accommodations may be made to enable individuals with disabilities to perform the essential functions of this position in compliance with the Americans with Disabilities Act of 1990.  Candidates may be required to go through a pre-employment criminal background check. 

HealthEdge is an equal opportunity employer. We are committed to workforce diversity and actively encourage all qualified persons to seek employment with us, including, but not limited to, racial and ethnic minorities, women, veterans and persons with disabilities. 

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**The annual US base salary range for this position is $148,000 to $156,000. This salary range may cover multiple career levels at HealthEdge. Final compensation will be determined during the interview process and is based on a combination of factors including, but not limited to, your skills, experience, qualifications and education.