Compliance Regulatory Analyst II

Behavior Frontiers

Salary Range: $75,000 - $102,000

Position Summary

The Compliance Regulatory Analyst II supports the organization's compliance program through regulatory monitoring, payer oversight, research, analysis, and implementation support. This position monitors and interprets healthcare regulations, Medicaid requirements, contractual obligations, and payer standards, with primary focus on Detroit Wayne Integrated Health Network (DWIHN) and other major payers. The Analyst partners with clinical and operational teams to assess regulatory impacts, maintain compliance tracking tools, support implementation of new requirements, strengthen audit readiness, and identify compliance risk.

Essential Duties and Responsibilities

· Monitor federal, state, Medicaid, contractual, and payer requirements affecting organizational operations and service delivery.

· Monitor, analyze, and support implementation of DWIHN requirements and other assigned major payer obligations.

· Review payer manuals, provider bulletins, contracts, regulatory guidance, policy updates, audit findings, and related communications to identify new or changing requirements.

· Conduct regulatory research and prepare impact assessments, compliance summaries, and implementation recommendations.

· Maintain regulatory trackers, payer requirement inventories, compliance calendars, evidence repositories, and implementation records.

· Identify affected departments, required actions, training needs, responsible owners, and implementation deadlines associated with regulatory changes.

· Partner with Clinical, Operations, Billing and Authorizations, Credentialing, Human Resources, Training, and other departments to support implementation of payer and regulatory requirements.

· Support readiness for DWIHN and other payer audits, regulatory reviews, licensing reviews, and contractual assessments.

· Coordinate audit evidence collection and assist with responses to regulatory and payer requests.

· Support the development, tracking, and validation of corrective action plans resulting from payer or regulatory findings.

· Identify emerging compliance risks, implementation gaps, and recurring issues and escalate significant concerns to Compliance leadership.

· Develop compliance guidance, quick-reference tools, regulatory summaries, and educational materials.

· Support development and revision of policies and procedures affected by regulatory or payer changes.

· Prepare regulatory dashboards, status reports, risk summaries, and leadership updates.

· Maintain accurate and organized regulatory and payer compliance documentation.

· Perform other duties as assigned.

Requirements

Required Qualifications

· Bachelor's degree in Healthcare Administration, Public Health, Compliance, Business Administration, Legal Studies, Nursing, or a related field.

· Two to five years of experience in healthcare compliance, regulatory affairs, audit, quality, payer relations, managed care, or healthcare operations.

· Experience researching and interpreting healthcare regulations, Medicaid requirements, contracts, or payer guidance.

· Strong analytical and critical-thinking skills with the ability to translate complex requirements into clear, actionable guidance.

· Strong written and verbal communication skills.

· Excellent organization, project coordination, documentation, and follow-through skills.

· Ability to manage multiple regulatory priorities and deadlines.

· Proficiency with Microsoft Office applications, including Excel.

Preferred Qualifications

· Behavioral health, applied behavior analysis (ABA), Medicaid, or managed care experience.

· Experience with DWIHN or Michigan Medicaid requirements.

· Experience working with Medicaid managed care organizations or other major healthcare payers.

· Experience supporting payer audits, regulatory reviews, corrective action plans, or compliance monitoring activities.

· Experience with multi-state healthcare operations.

· CHC, CHPC, CCEP, RHIA, RHIT, or a comparable healthcare compliance credential.

Knowledge, Skills, and Abilities

· Knowledge of healthcare compliance, Medicaid requirements, payer oversight, regulatory monitoring, and audit readiness.

· Ability to research and interpret complex healthcare and payer requirements.

· Ability to identify operational impacts and convert regulatory requirements into practical implementation steps.

· Strong attention to detail and ability to maintain accurate regulatory documentation.

· Strong analytical, problem-solving, and organizational skills.

· Ability to communicate effectively with clinical, operational, and administrative stakeholders.

· Ability to work independently while collaborating effectively across departments.

· Demonstrated professionalism, sound judgment, discretion, integrity, and commitment to confidentiality.

Success Measures

· Regulatory and payer updates are identified, analyzed, and communicated timely.

· DWIHN and other assigned payer requirements are accurately tracked.

· New or revised requirements have documented owners, implementation activities, and completion status.

· Regulatory and payer audit documentation is organized and readily available.

· Compliance risks and implementation barriers are identified and escalated appropriately.

· Corrective actions are effectively tracked through completion.

· Operational teams receive clear, actionable guidance regarding payer and regulatory requirements.

· Regulatory trackers, calendars, evidence, and supporting documentation remain complete and current.

Equal Employment Opportunity

The organization is an equal opportunity employer and considers qualified applicants without regard to protected characteristics under applicable federal, state, and local law. Reasonable accommodations are available to qualified individuals with disabilities throughout the application and employment process.

Benefits

Why Behavior Frontiers is perfect for you: 

• Competitive pay with optional On-demand paychecks thru DailyPay - get paid on your own schedule!
• 401K Plan with company match after 6 months of employment
• Paid Personal Time Off
• Paid Holidays
• Paid Sick Leave
• Medical, Dental and Vision insurance
• Opportunities for career advancement
• Performance and promotion raises
• Free Telehealth: Free 24/7 access to a doctor via telehealth for you and your dependents with no limits and no co-pays
• Free Telehealth Mental Health: Free access to a mental health counselor via telehealth for you and your dependents (over age 13) with no limits or co-pays
• Employee Assistance Program: Free access to some support services (financial, legal, counseling, etc.)
• Fitness: Discounted monthly gym membership to 12,000 gym locations nationwide, as well as free access to workout videos
• Deals: Exclusive discounts and savings to 500+ companies and more!
• Travel: Discounts on travel essentials including hotels, rental cars, flights, excursions, and more!
• Lab Testing Discounts:10-80% off costs of routine lab work
• New Benefits Rx: Discounts on prescription medications from 10-80% at 60,000+ locations nationwide

Why work for Behavior Frontiers? Visit our benefits & perks page to learn more!

Behavior Frontiers is an Equal Opportunity Employer and will consider for employment all qualified applicants in a manner consistent with the requirements of the applicable federal, state, and local laws.