💼 About This Role

You'll serve as the organization's subject matter expert on regulatory compliance for self-funded health plans, owning all mandated reporting obligations including CMS Section 111, RxDC, and PCORI filings. You'll lead Transparency in Coverage and No Surprises Act compliance efforts, and coordinate Fraud, Waste & Abuse investigations with external agencies. This role offers the chance to impact healthcare affordability in a dynamic environment.

🎯 What You'll Do

• Execute CMS Section 111 MSP reporting and error resolution
• Manage RxDC and PCORI filings for self-funded plans
• Administer Gag Clause Prohibition Attestation and TiC compliance
• Coordinate Fraud, Waste & Abuse detection and external referrals

📋 Requirements

• 5 years of experience in health care compliance
• Experience with self-funded or level-funded group health plans
• Knowledge of CMS Section 111 and RxDC reporting
• Familiarity with No Surprises Act and Transparency in Coverage

✨ Nice to Have

• Experience with Fraud, Waste & Abuse programs
• Knowledge of federal regulatory agencies (CMS, DOL, IRS)
• Experience drafting SPDs and SBCs

🎁 Benefits & Perks

• 💰 Competitive salary with equity and bonus
• 🏖️ Flexible remote work
• 🩺 Health benefits
• 📈 Professional development