Regulatory Process Manager

Job Summary

Serving as the subject matter expert, the full-time Regulatory Process Manager will independently investigate complex issues within the No Surprises Act IDR process, interpret regulations, and recommend process improvements while working remotely.

Key responsibilities

• Interpret NSA rules and investigate complex exceptions in case files to identify root causes and recommend improvements
• Manage escalated disputes through resolution, coordinating with QA, compliance, and operations
• Track CMS guidance and communicate relevant changes to internal stakeholders proactively

Required qualifications

• JD or LLM preferred; significant NSA/IDRE operational, regulatory, or arbitration experience considered in lieu
• Deep familiarity with the No Surprises Act IDR process
• Experience identifying patterns across large case volumes and translating them into process improvements
• Prior experience in IDRE, IRO, managed care, utilization review, or healthcare regulatory environments
• Arbitration experience, particularly in IDR arbitration, is ideal