Associate, UM Regulatory Operations

This position is posted by Jobgether on behalf of a partner company. We are currently looking for a Associate, UM Regulatory Operations in United States.

This role sits at the intersection of healthcare operations, regulatory compliance, and cross-functional program execution, supporting utilization management (UM) processes within a fast-paced insurance environment. You will help ensure regulatory requirements are accurately interpreted, implemented, and maintained across multiple initiatives impacting members and operational teams. The position involves coordinating complex, multi-stakeholder projects while translating regulatory and operational needs into structured plans and actionable deliverables. You will work closely with compliance, legal, clinical, and technical teams to support audits, filings, and regulatory reporting requirements. This is a highly collaborative role where analytical thinking, attention to detail, and strong communication are essential. You will contribute directly to improving process efficiency, compliance accuracy, and overall program effectiveness.

Accountabilities

In this role, you will oversee and support the execution of cross-functional initiatives tied to regulatory operations and utilization management processes, ensuring alignment, compliance, and timely delivery across stakeholders. You will also play a key role in monitoring performance, improving workflows, and supporting regulatory readiness.

Lead and coordinate end-to-end project and implementation activities, including planning, stakeholder management, timeline tracking, and risk mitigation across UM regulatory initiatives
Support regulatory operations such as market conduct exams, URA filings, NCQA submissions, license renewals, and Mental Health Parity compliance activities
Gather, document, and translate business and regulatory requirements into structured workflows, operational procedures, and implementation plans
Analyze operational data and performance metrics to identify trends, gaps, and opportunities for process and compliance improvements
Collaborate with cross-functional teams including compliance, legal, clinical, and technical stakeholders to ensure consistent interpretation and execution of regulations
Develop reporting, presentations, and documentation to communicate findings, recommendations, and regulatory impacts to internal stakeholders
Contribute to workflow optimization and continuous improvement initiatives across UM operations and regulatory processes

Requirements

The ideal candidate brings experience in healthcare operations, regulatory compliance, and project coordination, with strong analytical and communication skills. You are comfortable working across complex stakeholder environments and translating regulatory requirements into practical execution.

Bachelor’s degree or equivalent experience in healthcare, business, public health, or related field
3+ years of experience in healthcare utilization management, health insurance operations, or a related regulated industry
Experience supporting regulatory compliance activities such as NCQA, MHPAEA, audits, filings, or market conduct exams
Experience managing or supporting end-to-end projects, process improvements, or operational implementations
Strong ability to analyze data, document workflows, and interpret regulatory or operational requirements
Proficiency with Microsoft Office or Google Workspace tools, with strong skills in Excel or equivalent tools preferred
Excellent communication skills with the ability to translate complex information for both technical and non-technical audiences
Strong organizational skills with the ability to manage multiple priorities in a deadline-driven environment

Benefits

Competitive annual base salary range (depending on experience and location)
Annual performance bonus eligibility
Unlimited paid time off policy
Comprehensive medical, dental, and vision insurance
401(k) retirement savings plan
Paid parental leave
Paid sick leave and wellness resources
Remote work flexibility (within eligible U.S. locations)
Professional development and growth opportunities

How Jobgether works:

We use an AI-powered matching process to ensure your application is reviewed quickly, objectively, and fairly against the role's core requirements. Our system identifies the top-fitting candidates, and this shortlist is then shared directly with the hiring company. The final decision and next steps (interviews, assessments) are managed by their internal team.

We appreciate your interest and wish you the best!

Why Apply Through Jobgether?

Data Privacy Notice: By submitting your application, you acknowledge that Jobgether will process your personal data to evaluate your candidacy and share relevant information with the hiring employer. This processing is based on legitimate interest and pre-contractual measures under applicable data protection laws (including GDPR). You may exercise your rights (access, rectification, erasure, objection) at any time.

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Associate, UM Regulatory Operations

Requirements

Benefits

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