Sr. Regulatory Compliance Analyst

Job Description

Job Description

Vālenz® Health is the platform to simplify healthcare – the destination for employers, payers, providers and members to reduce costs, improve quality, and elevate the healthcare experience. The Valenz mindset and culture of innovation combine to create a distinctly different approach to an inefficient, uninspired health system. With fully integrated solutions, Valenz engages early and often to execute across the entire patient journey – from care navigation and management to payment integrity, plan performance and provider verification. With a 99% client retention rate, we elevate expectations to a new level of efficiency, effectiveness and transparency where smarter, better, faster healthcare is possible.

About This Opportunity :

As a Senior Regulatory Compliance Analyst with Valenz, you’ll play a central role in advancing our Corporate Compliance Program. You’ll lead audits and risk assessments, manage compliance inquiries, and interpret complex regulatory requirements. Acting as a compliance business partner across Valenz service lines (claims, utilization management, repricing, and care navigation), you’ll ensure adherence to applicable laws, contracts, and delegated functions while helping translate regulations into practical, actionable guidance for our teams.

Things You’ll Do Here :

• Lead internal audits, operational reviews, and risk assessments, including pre- and post-implementation evaluations.
• Manage the development, revision, and documentation of compliance policies, procedures, and training materials.
• Serve as the primary intake for compliance-related questions, Hotline submissions, and incident reports; provide timely, well-reasoned recommendations.
• Collaborate with leadership on mitigation plans and root cause analysis tied to regulatory or contractual noncompliance.
• Represent Compliance in client-facing meetings, audits, and business reviews.
• Monitor and interpret applicable laws, regulations, and delegation requirements (ERISA, HIPAA, CMS, HHS-OCR, DOL, URAC, NCQA), translating them into practical guidance.
• Review healthcare claims, coding structures (ICD-10, DRG, CPT), and workflows to identify risks and ensure compliance.
• Support vendor and third-party compliance documentation, including audit coordination and follow-up.
• Maintain compliance logs, records, and investigation documentation.
• Assist with board-level reporting, internal committee materials, and responses to payer / client audits of delegated functions.
• Serve as a trusted compliance partner to operational, legal, and product teams.
• Contribute to scalable compliance processes, onboarding, and training for future compliance staff.

Reasonable accommodation may be made to enable individuals with disabilities to perform essential duties.

What You’ll Bring to the Team :

A plus if you have :

Where You’ll Work : This is a fully remote position, and we’ll provide all the necessary equipment!

Why You'll Love Working Here

Valenz is proud to be recognized by Inc. 5000 as one of America’s fastest-growing private companies. Our team is committed to delivering on our promise to engage early and often for smarter, better, faster healthcare . With this commitment, you’ll find an engaged culture – one that stands strong, vigorous, and healthy in all we do.

Benefits

At Valenz, we celebrate, support, and thrive on inclusion, for the benefit of our associates, our partners, and our products. Valenz is committed to the principle of equal employment opportunity for all associates and to providing associates with a work environment free of discrimination and harassment. All employment decisions at Valenz are based on business needs, job requirements, and individual qualifications, without regard to race, color, religion or belief, national, social, or ethnic origin, sex (including pregnancy), age, physical, mental or sensory disability, HIV Status, sexual orientation, gender identity and / or expression, marital, civil union or domestic partnership status, past or present military service, family medical history or genetic information, family or parental status, or any other status protected by the laws or regulations in the locations where we operate. We will not tolerate discrimination or harassment based on any of these characteristics.

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