Senior Regulatory Research Analyst

Inovalon was founded in 1998 on the belief that technology, and data specifically, would empower the transformation of the entire healthcare ecosystem for the better, improving both outcomes and economics. At Inovalon, we believe that when our customers are successful in their missions, healthcare improves. Therefore, we focus on empowering them with data-driven solutions. And the momentum is building.

Together, as ONE Inovalon, we are a united force delivering solutions that address healthcare’s greatest needs. Through our mission-based culture of inclusion and innovation, our organization brings value not just to our customers, but to the millions of patients and members they serve.

Inovalon was founded in 1998 on the belief that technology, and data specifically, would empower the transformation of the entire healthcare ecosystem for the better, improving both outcomes and economics. At Inovalon, we believe that when our customers are successful in their missions, healthcare improves. Therefore,
we focus on empowering them with data-driven solutions. And the momentum is building. Together, as ONE Inovalon, we are a united force delivering solutions that address healthcare’s greatest needs. Through our mission-based culture of inclusion and innovation, our organization brings value not just to our customers, but to the millions of patients and members they serve.

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. This role may oversee/lead the work of other research consultants, analysts or vendors who may be assisting on projects.

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 lnovalon's policies, procedures and mission statement.


• Adhere to all confidentiality and HIPAA requirements as outlined within lnovalon's Operating Policies and Procedures in all ways and at all times with respect to any aspect of the data handled or services rendered in the undertaking of the position.


• Fulfill those responsibilities and/or duties that may be reasonably provided by lnovalon 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.


• We reserve the right to change this job description from time to time as business needs dictate and will provide notice of such.

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.


• Combination of corporate and vendor/ consulting side experience a plus. 

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.
  A team player with a positive, ‘can-do’ attitude who brings creative thinking and high energy.

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. 


• The employee may occasionally need to stand, walk, or lift and/or move up to 10 pounds.


• Reasonable accommodations may be made to enable individuals with disabilities to perform the essential functions.