Sr. Healthcare Compliance Analyst

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 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. Reasonable accommodation may be made to enable individuals with disabilities to perform essential duties. What You’ll Bring to the Team: • Bachelor’s degree in healthcare administration, legal studies, public policy, or related field. • 5+ years of healthcare compliance experience. • Strong knowledge of federal and state healthcare regulatory frameworks (ERISA, Medicare, HIPAA, state-level utilization/case management). • Experience with claims review and healthcare coding standards. • Ability to work independently, manage competing priorities, and provide actionable real-time guidance. • Proven ability to lead complex projects and serve as a subject matter expert within cross-functional teams. A plus if you have: • CHC (Certified in Healthcare Compliance) highly preferred. • CPC (Certified Professional Coder) highly preferred. • Experience in managed care, self-insured plans, stop-loss administration, or TPA operations. • Prior work in a growing or fast-paced organization; start-up experience. • Familiarity with cross-functional collaboration across Legal, Product, and Operational teams. • Experience building compliance frameworks or training others in area-specific requirements. Where You’ll Work: This is a fully remote position, and we’ll provide all the necessary equipment! • Work Environment: You’ll need a quiet workspace that is free from distractions. • Technology: Reliable internet connection—if you can use streaming services, you’re good to go! • Security: Adherence to company security protocols, including the use of VPNs, secure passwords, and company-approved devices/software. • Location: You must be US based, in a location where you can work effectively and comply with company policies such as HIPAA. 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 • Generously subsidized company-sponsored Medical, Dental, and Vision insurance, with access to services through our own products, Healthcare Blue Book and KISx Card. • Spending account options: HSA, FSA, and DCFSA • 401K with company match and immediate vesting • Flexible working environment • Generous Paid Time Off to include vacation, sick leave, and paid holidays • Employee Assistance Program that includes professional counseling, referrals, and additional services • Paid maternity and paternity leave • Pet insurance • Employee discounts on phone plans, car rentals and computers • Community giveback opportunities, including paid time off for philanthropic endeavors 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. Powered by JazzHR Es9oz9AN0y Apply tot his job