Senior Regulatory Research Analyst

About the job

Overview: The Senior Regulatory Research Analyst will analyze regulatory changes in the US Healthcare market focusing on Federal and State regulatory changes that impact the Health Insurance Carrier (Payers). This role deeply understands and summarizes regulatory changes and recommends strategic and/or tactical actions based on research and interpretation. Areas of responsibility will include Risk adjustment programs rules and changes, HEDIS, STARS, state specific quality programs, and changes to regulations around HIPPA, PHI, PII or other regulations from CMS or laws enacted by the federal congress. Duties and Responsibilities: • Work cross-functionally to manage all aspects of research projects within the Regulatory Research Program to better understand and improve the company's compliance and competitive position. • Manage product-specific research programs to achieve continuous incremental improvement. • Support Inovalon departments to define research scope and recommend best methodologies. • Continually monitor Federal and State regulations including previews and notice periods and track all scheduled/planned regulatory changes in a comprehensive and dynamic tracker. • Resourcefully collect and analyze secondary and primary research data that is needed to understand the regulatory landscape, competitive implications, and potential impacts on healthcare payers and related products. • Distill and synthesize conclusions and communicate them clearly, accurately, and compellingly in PowerPoint presentations. • Proactively recommend research process improvements to increase efficiency and consistency of the Research and Competitive Insights function. • Maintain compliance with Inovalon's policies, procedures and mission statement. • Adhere to all confidentiality and HIPAA requirements as outlined within Inovalon’s Operating Policies and Procedures. • Fulfill those responsibilities and/or duties that may be reasonably provided by Inovalon for the purpose of achieving operational and financial success of the Company. • Uphold responsibilities relative to the separation of duties for applicable processes and procedures within your job function. Education: • Bachelor's Degree in Arts/Sciences (B.A./B.S.) in relevant field required • Master's Degree in Arts/Sciences (M.A./M.S.) in Law, Public Policy, Healthcare policy, or research is a plus preferred Juris Doctorate Degree (J.D.) Law degree, legal training, or Healthcare Policy/legislation experience preferred Experience: • 5+ Years of previous work experience in US Healthcare Regulatory Research, CMS/HHS Policy interpretation, or legal interpretation role involving hands-on project work. • Experience with Quality Management programs (HEDIS®, ACA, state quality programs) and Risk Adjustment (Medicare Advantage, Managed Medicaid, ACA) preferred. Skills and Abilities: • Proven track record of qualitative and quantitative research in the US healthcare space. • Exceptional analytical, verbal and written communication skills. • Experience working with cross functional staff, management, and senior executives. • Must be proficient at data analysis. • Previous research experience in healthcare or healthcare technology preferred. Working Conditions and Physical Demands: • This is a primarily sedentary role. The employee is regularly required to sit, talk, and hear for extended periods of time, and also required to repetitively use manual labor to operate a computer keyboard and other office equipment. • Reasonable accommodations may be made to enable individuals with disabilities to perform the essential functions.