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Ankura

Senior Associate, Government Programs Compliance and Regulatory

Posted 21 days ago
2-5 years experience
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AI Summary

The Senior Associate will conduct regulatory research and analyze health plan data, policies, and operational processes to ensure compliance with government programs. They will also develop findings, reports, and presentations while coordinating project workstreams and collaborating with client stakeholders.

Ankura is a team of excellence founded on innovation and growth.

Role Overview

Ankura is seeking a Senior Associate to support client engagements involving compliance, operational, and regulatory matters across Medicare Advantage, Medicaid managed care, and Affordable Care Act programs.

The Senior Associate will conduct regulatory research; analyze health plan data, documentation, policies, and operational processes; and develop findings, workpapers, reports, presentations, and other client deliverables. The successful candidate will understand how CMS guidance, state contractual requirements, and other regulatory expectations translate into day-to-day health plan operations.



Responsibilities

  • Conduct research and analysis of federal and state regulatory requirements applicable to Medicare Advantage, Medicaid managed care, and Affordable Care Act programs.
  • Interpret CMS guidance, state Medicaid contracts, regulatory communications, and other requirements to evaluate their impact on health plan operations.
  • Review health plan policies, procedures, reports, data, operational documentation, and other supporting materials to assess compliance with applicable requirements.
  • Analyze regulatory and operational issues, identify potential gaps or areas of risk, and communicate findings clearly to engagement leadership.
  • Develop clear, accurate, and well-supported workpapers, findings, reports, presentations, and other client deliverables.
  • Take ownership of defined project workstreams, including coordinating assigned activities, monitoring progress, and completing deliverables within established timelines.
  • Work with Project Managers and other engagement leaders to understand client concerns, define project objectives, and develop effective work plans.
  • Apply structured problem-solving and critical-thinking skills to complex regulatory, compliance, and operational questions.
  • Communicate project updates, emerging issues, and findings to engagement leadership in a timely manner.
  • Collaborate effectively with colleagues and client stakeholders to build and maintain strong working relationships.
  • Review and provide guidance on work completed by junior team members, as appropriate.
  • Support the successful completion of high-quality client deliverables within the desired timeframe.
  • Contribute to practice development, internal knowledge sharing, and the continued development of tools, methodologies, and service offerings.
  • Maintain the confidentiality of client information and understand the importance of privileged and confidential communications.

Qualifications

  • Bachelor’s degree from an accredited college or university.
  • Approximately three to five years of relevant experience in health plan compliance, regulatory affairs, health plan operations, consulting, or a related field.
  • Experience working with Medicare Advantage, Medicaid managed care, Affordable Care Act programs, or other government-sponsored health care programs.
  • Working knowledge of CMS guidance, state Medicaid contractual requirements, and the operational processes used by health plans to implement regulatory requirements.
  • Experience conducting regulatory research and translating complex requirements into practical operational considerations.
  • Experience analyzing health plan data, policies, procedures, documentation, or operational processes.
  • Strong analytical, critical-thinking, and problem-solving skills.
  • Demonstrated ability to develop clear, concise, and well-supported written analyses and client deliverables.
  • Excellent written and verbal communication skills.
  • Ability to manage multiple assignments, establish priorities, and meet deadlines in a client-service environment.
  • Ability to work effectively both independently and as part of a collaborative engagement team.
  • Experience supporting or guiding junior team members is preferred.
  • Proficiency in Microsoft Excel, Word, and PowerPoint, including the ability to develop reports, workpapers, analyses, and presentations.
  • Willingness to travel based on client and engagement needs.

Preferred Qualifications

  • Consulting or professional services experience.
  • Experience assessing health plan compliance with regulatory or contractual requirements.
  • Experience with compliance audits, operational reviews, risk assessments, corrective action plans, or regulatory readiness activities.
  • Familiarity with multiple functional areas of health plan operations.
  • Experience interacting directly with clients or senior internal stakeholders.

#LI-Remote #LI-NB1

Ankura is an Affirmative Action and Equal Opportunity Employer. All qualified applicants will receive consideration for employment without regard to race, color, religion, sex, sexual orientation, gender identity, national origin, or protected veteran status and will not be discriminated against based on disability. Equal Employment Opportunity Posters, if you have a disability and believe you need a reasonable accommodation to search for a job opening, submit an online application, or participate in an interview/assessment, please email accommodations@ankura.com or call toll-free +1.312-583-2122. This email and phone number are created exclusively to assist disabled job seekers whose disability prevents them from being able to apply online. Only messages left for this purpose will be returned. Messages left for other purposes, such as following up on an application or technical issues unrelated to a disability, will not receive a response.

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