Associate, UM Regulatory Operations at Jobgether – United States

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.

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

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

• 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