Healthcare Regulations Expert

2 days ago


Salem, Tamil Nadu, India beBeeRegulation Full time ₹ 8,00,000 - ₹ 15,00,000

The role of a Business Development Manager requires specialized knowledge in healthcare regulations and compliance.

Key Responsibilities
  • Gather, analyze, and document business requirements related to HIPAA, CMS, NCQA, and state-specific regulations. Ensure system changes, processes, and documentation remain compliant with these regulations.
  • Act as liaison with the compliance and legal teams during audits or regulatory updates. This involves providing expert advice on how to address any compliance issues that may arise.
  • Benefit Codes & Plan Configuration: Analyze and configure benefit codes for medical, dental, pharmacy, and specialty products. Collaborate with product and IT teams to ensure accurate coding, claims adjudication, and eligibility processing.
  • Collateral & Member Materials: Coordinate development and validation of member-facing collateral such as Explanation of Benefits (EOBs), Summary of Benefits and Coverage (SBCs), provider directories, and plan brochures. Partner with marketing and compliance teams to ensure content accuracy, regulatory alignment, and timely delivery.
Required Skills and Qualifications

A successful candidate will have:

  • Proven experience in healthcare regulations and compliance.
  • Excellent analytical and problem-solving skills.
  • Strong communication and interpersonal skills.
  • Ability to work collaboratively with cross-functional teams.
Benefits

We offer a competitive compensation package, including:

  • Bonus structure tied to performance metrics.
  • Comprehensive health insurance.
  • Retirement savings plan.


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