Job Description

Department:

419 - Compliance and Legal

Reports To:

General Counsel and Compliance Officer

The

Compliance Analyst

is a full-time position within the Legal-Compliance Department reporting to the General Counsel & Compliance Officer that will carry out roles and responsibilities in accordance with this job description, the Code of Conduct & Values, assignments, and applicable legal, corporate, and department requirements. The Legal-Compliance Department is responsible for the legal, compliance, Code of Conduct, corporate governance, and government relations functions of the company under the leadership of the General Counsel, who also serves as the Compliance Officer, Corporate Secretary, and Senior Management Team member of the company.

Legal-Compliance Department Mission

Serve & assist the company achieve its Mission and Strategic Goals in accordance with the Values and legal-regulatory requirements. Advise the company in legal, compliance, business, and industry trends, developments & practices. Drive on-going: operational efficiency; financial integrity; compliance assurance; effective ERM & Corporate Governance; and ethical, common-sense decision-making and action under the Values. Deliver timely, responsive, competent, and quality service, deliverables, and support in the best interests of the company. Always maintain a reputation as a positive, professional, and trustworthy thought partner at all levels of the company, and with the customers and stakeholders of the company, in accordance with the Mission, Values, & Code of Conduct.

Key Responsibilities:

Assist in the design, execution, and maintenance of the annual compliance plan by providing assessment, analysis, reporting, and awareness & training deliverables in accordance with established department policies and procedures.

Prepare and file all policy form, rate, and material filings with regulatory agencies in collaboration with other corporate departments to assure compliance, quality, and timeliness that will maximize regulatory approval outcomes in alignment with the strategic business needs while maintaining strong regulatory relationships in accordance with the Values.

Prepare, submit, and oversee the company's compliance with all regulatory and association filing and reporting requirements on an annual and quarterly basis, reporting issues to management, in accordance with established department policies and procedures.

Oversee and facilitate the processing of all formal appeals and grievances in collaboration with other corporate departments to assure compliance with established legal, regulatory, and corporate requirements in accordance with established department policy and procedure and the Values.

Review, analyze, prepare, and submit formal responses, in collaboration with other internal departments, to any formal complaint, inquiry, or request (including external exam or audit coordination) submitted to the company by a regulatory or non-regulatory entity involving compliance issues in a timely, responsive, and quality-assurance manner that maintains strong regulatory relationships in accordance with established department policies and procedures.

Stay updated on all relevant laws, regulations and industry standards related to the company's business.

Developing and delivering compliance communications and training to departments, employees and other customers and stakeholders of the company in accordance with established department policies and procedures.

Identify and analyze compliance risks and facilitate responsive action with departments to remediate, mitigate, and manage in the best interests of the company in accordance with established department policies and procedures.

Conduct internal audits, assessments, and surveys to evaluate compliance with legal, regulatory, and corporate requirements or support effective Enterprise Risk Management (ERM) practices in accordance with established department policies and procedures.

Investigate compliance concerns, incidents, or alleged violations of legal, regulatory, or corporate requirements.

Assist with design, implementation, and maintenance of formal policies, procedures, and controls across the enterprise in partnership with the quality function.

Qualifications:

The successful candidate will have a bachelor's degree from an accredited institution plus 3 to 5 years' experience. The position will involve significant contact with management and personnel of the company and requires strong interpersonal, professional, and communication skills. Demonstrated business judgment, common sense, and ethical behavior. The candidate must be a demonstrated self-starter who is both highly organized, positive, and professional collaborator. The candidate must be legally authorized to work in the United States of America and successfully pass background checks and drug testing.

Performance Expectations:

Perform other work-related duties as assigned by the General Counsel & Compliance Officer.

Comply with department and corporate administrative procedures, policies, and best practices.

General working knowledge of Microsoft Office programs including MS Word, Excel, Forms, & PowerPoint needed. Prior experience utilizing Adobe Acrobat a plus.

Communicate, correspond, and interact with clients and outside entities, such as government agencies, corporations, and other offices to gather information or data.

Complies with department and corporate administrative procedures and requirements including weekly and monthly deadlines for submitting time sheets, time entries, status reports, and availability updates.

Maintain strict confidentiality of the company's internal business affairs and protected information. Understands the values and ethics of the position, including ethical rules on confidentiality and company representation.

Exemplify trust, professionalism, and positivity in alignment with company values and the duties of loyalty and care on behalf of the Legal-Compliance Department. Strives for excellence, quality, timeliness, responsiveness, critical thought, common sense, discernment, efficiency, and value.

Interacts effectively and professionally with clients and personnel at all levels, including executives, directors, managers, co-workers, and support staff.

Owns professional development by seeking feedback, accepting constructive input, editing work, and learning new skills.

Embraces new processes and incorporates new technology to meet evolving company demands.

Responds quickly and positively to shifting demands and opportunities; works under tight deadlines and manages multiple detailed tasks regardless of instruction level.

Contributes as a positive, team-oriented member by sharing information, goals, opportunities, successes, and failures with appropriate parties.

Plans, organizes, and completes multiple related tasks efficiently.

Communicates strongly (verbally and in writing) and exerts influence across all levels of the organization.

Analyzes complex information, identifies risks, and develops sound recommendations.

Solves problems, identifies issues and root causes, and works with minimal supervision.

Anticipates problems and issues, exercising independent judgment to resolve them.

Delivers high-quality work products and demonstrates ownership through follow-up and follow-through.

Works independently and collaboratively in a fast-paced environment.

Functions effectively in a multi-office and culturally and educationally diverse environment.

Lifts boxes up to 20 pounds.

Travels on short notice and works overtime as needed, including nights and weekends.

Required Qualifications:

Bachelor's degree from an accredited institution.

Three 3 years' experience.

Strong interpersonal, professional, and communication skills.

Demonstrated business judgment, common sense, and ethical behavior.

Demonstrated self-starter who is both highly organized, positive, and professional collaborator.

Legally authorized to work in the United States of America.

Successfully pass background checks and drug testing.

Preferred Qualifications:

Competencies & Proficiency Levels Insert Grid

Regulatory Knowledge

Deep understanding of healthcare laws (HIPAA, ACA, CMS, ERISA) and insurance regulations.

Accuracy in interpretation; audit outcomes.

Advises leadership; updates policies; ensures compliance.

Risk Assessment & Mitigation

Identifies and evaluates compliance risks across operations.

Risk reduction; incident prevention.

Conducts assessments; recommends controls.

Policy Development & Implementation

Creates and enforces compliance policies and procedures.

Policy clarity; staff adherence.

Drafts policies; trains staff; monitors effectiveness.

Legal Collaboration

Works with legal counsel on investigations and regulatory matters.

Resolution quality; legal alignment.

Coordinates with counsel; prepares documentation.

Compliance Program Oversight

Designs and manages the enterprise-wide compliance program.

Program effectiveness; stakeholder engagement.

Conducts reviews; reports to leadership; updates plans.

Audit & Monitoring

Develops internal audit protocols and monitors compliance.

Audit findings; corrective actions.

Leads audits; tracks issues; ensures follow-up.

Reporting & Documentation

Maintains accurate compliance records and reporting systems.

Timeliness; completeness.

Prepares reports; manages hotline; tracks investigations.

Training & Education

Develops and delivers compliance training across the organization.

Training completion; knowledge retention.

Designs modules; facilitates sessions; evaluates impact.

Ethical Leadership

Models integrity and promotes a culture of compliance.

Trust scores; ethical incident rates.

Leads by example; enforces standards.

Communication & Influence

Communicates complex regulations clearly and persuasively.

Message clarity; stakeholder buy-in.

Prepares briefs; presents findings; advises teams.

Stakeholder Engagement

Builds relationships with regulators, executives, and staff.

Collaboration quality; feedback.

Hosts briefings; attends forums; responds to inquiries.

Continuous Improvement

Updates practices based on regulatory changes and feedback.

Innovation; adaptability.

Reviews trends; pilots improvements; revises protocols.

What it Takes to be a Strong Team Player in this Role:1. Performance Excellence

Accuracy: Maintains a claims data entry accuracy rate of 95% or higher.

Call Quality: Achieves a minimum score of 3.0 on call quality assessments.

Responsiveness: Responds to member inquiries promptly and professionally across all channels (phone, email, chat).

Efficiency: Manages high call volumes while maintaining service standards and composure.

2. Competency Demonstration

Applies problem-solving skills to resolve member issues effectively.

Demonstrates empathy and professionalism in every interaction.

Uses positive language and confirms understanding to ensure clarity.

Collaborates with team members and supports a values-based culture.

Navigates systems and tools with technical proficiency and accuracy.

3. Behavioral Impact

Customer Satisfaction: Consistently receives positive feedback from members and internal stakeholders.

Team Contribution: Shares knowledge, supports peers, and contributes to team goals.

Adaptability: Maintains effectiveness under pressure and adapts to changing priorities.

Ownership: Takes initiative to resolve issues and follow through on commitments.

4. Alignment with Company Values

Embodies and promotes the company's vision and mission in daily work.

Acts as a role model for company values and behaviors.

Participates in creating a fun, positive, and successful work environment.

Position Description Disclaimer and Additional Duties

This job description provides a general overview of the responsibilities, scope, and level of work expected for the designated role. It may not be an exhaustive list of duties, tasks, or qualifications, nor does it define the specific responsibilities of any individual employee. The employee may be required to perform other related duties, within the scope of their knowledge, skills, and abilities, to meet the evolving needs of the organization. Duties and responsibilities may be modified, assigned, or directed by management at any time, with or without prior notice.

To apply, please visit our website:

https://rhsc.wd5.myworkdayjobs.com/DDNM/job/Albuquerque-NM/Compliance-Analyst_JR101039

Job Type: Full-time

Pay: $65,000.00 - $75,000.00 per year

Benefits:

401(k) 401(k) matching Dental insurance Employee assistance program Flexible spending account Health insurance Life insurance Paid time off Parental leave Professional development assistance Referral program Tuition reimbursement Vision insurance
Work Location: In person