Job Closed

This listing is no longer active.

Kaiva Tech logo
Kaiva Tech

Kaiva Corporation is a proud Equal Opportunity Employer! All qualified applicants will receive consideration for employment without regard to race, color, religion, sex, gender identity, sexual orientation, national origin, disability or veteran status.

Regulatory Case Analyst

Business AnalystBusiness AnalystOtherRemoteTeam 11-50

Location

United States

Posted

144 days ago

Salary

0

No structured requirement data.

Job Description

Regulatory Case Analyst

Kaiva Tech

Kaiva Tech, LLC is seeking a Regulatory Case Analyst Reports To: Program Manager Location: Remote Schedule: Monday – Friday Hours: Full-time, 40-hours/week FLSA Status: Hourly, Nonexempt Clearance: Public Trust Position Summary: The Regulatory Case Analyst supports the Department of Education, Federal Student Aid (FSA) Ombudsman by reviewing, analyzing, and resolving complex consumer financial and regulatory cases in accordance with applicable federal statutes (Title IV), regulations, and established program guidance. This role performs comprehensive case reviews, gathers and evaluates documentation from multiple sources, applies statutory and regulatory criteria, and prepares structured written determinations for both internal and government review. This position is accountable for maintaining high standards of accuracy, documentation integrity, and productivity within a performance-based contract environment. Essential Duties and Responsibilities: - Assess assigned cases to determine jurisdiction, scope, and appropriate course of action. - Perform detailed document reviews and comprehensive fact gathering from internal and external sources. - Evaluate cases in accordance with applicable federal statutes, regulations, and internal policies, including financial assistance or consumer protection frameworks as applicable. - Develop structured written analyses utilizing the Issue–Rule–Analysis–Conclusion (IRAC) methodology or a comparable analytical framework. - Prepare professional correspondence and resolution summaries for internal and government review. - Record all actions, findings, and outcomes in case management/CRM systems in accordance with documentation standards. - Maintain accuracy, completeness, and compliance with established quality assurance standards and performance metrics. - Manage assigned caseload to achieve defined productivity targets and service level requirements in a performance-based environment. - Engage in quality reviews, calibration sessions, training activities, and continuous improvement initiatives. - Submit Monthly Status Reports on a regular basis, as required. - Complete required compliance training as assigned. - Other duties as assigned. Knowledge and Critical Skills: - Capable of applying advanced analytical and critical thinking to complex regulatory scenarios. - Demonstrated expertise in structured professional writing and preparation of formal case determinations. - Proven capacity to manage multiple cases concurrently while maintaining accuracy and meeting productivity expectations. - Meticulous attention to detail and disciplined documentation practices. - Proficiency in Microsoft Office Suite applications. - Self-directed work style suited for an independent remote environment with high accountability and performance expectations. Education & Work Experience: - Bachelor's degree in Business, Public Administration, Legal Studies, Finance or related field. - Minimum of 4 years of progressive professional experience in regulatory case management, quality assurance, compliance review, or a closely related analytical field in lieu of a degree. - Extensive experience reviewing, interpreting, and synthesizing complex documentation and case records. - Practical experience operating within a CRM or case management system (Salesforce preferred). Certifications, Licenses: N/A Special Requirements: - Must be a U.S citizen. - Must be able to obtain and maintain Public Trust level clearance. Work Environment: Employee will primarily work remotely in a professional home office environment with standard computer and communications equipment. Typical indoor and computer related noise level, and typical office, paper, and equipment related dust. Exposure to video display terminals occurs on a regular basis. Physical Demands: To successfully perform the essential functions of the job, the employee needs to be able to sit at a workstation for extended periods; use hand(s) to handle or feel objects, tools, or controls; reach with hands and arms; talk and hear; see to read printed materials and computer screens; mobility to work in a typical office setting. Ability to work on desktop or laptop computer for extended periods of time reading, reviewing/analyzing information, and may be required to provide recommendations, summaries and/or reports in written format. Must be able to effectively communicate with others verbally and in writing. Employee must be able to lift and/or move moderate amounts of weight, typically up to 20 pounds. Regular and predictable attendance is essential.

Related Categories

Related Job Pages

More Business Analyst Jobs

Heartbeat Health logo

Technology Solutions Analyst

Heartbeat Health

We're on a mission to deliver the most effective, efficient, and engaging heart care in the world.

Business Analyst144 days ago
OtherRemoteTeam 11-50H1B Sponsor

• End-User Support and Technical Resolution • Request Management: Own and manage the lifecycle of all end-user support requests within the ticketing system. This includes triage, prioritization, assignment, escalation, and timely resolution of technical issues in alignment with Service Level Agreements (SLAs). • Enterprise Application Support: Serve as the primary point of contact for resolving complex technical issues and providing specialized support for all corporate applications, including SaaS platforms, and collaboration suites. • Identity and Access Management (IAM): Execute timely and accurate end-user provisioning and de-provisioning across all critical systems, ensuring compliance with security policies from onboarding through offboarding. • Security and Compliance Audits: Conduct comprehensive quarterly access reviews (QARs) to validate that users maintain the appropriate level of access necessary for their roles (Principle of Least Privilege), identifying and remediating any access discrepancies to maintain a strong security posture and meet regulatory requirements. • Device Configuration and Management: Oversee the entire lifecycle management of all corporate-owned devices (laptops, mobile devices, peripherals). This includes procurement, standardized imaging, deployment, configuration via Mobile Device Management (MDM) solutions, routine maintenance, inventory tracking, and eventual secure decommissioning. • Technology Operations and Security: Act as the administrator for a diverse portfolio of third-party, cloud-based applications including vendor management, license tracking, configuration changes, integration maintenance, performance monitoring, and ensuring vendor compliance with HBH security standards. • Security Awareness and Training: Develop, implement, and lead mandatory security awareness programs and training sessions for all HBH employees. • Standard Operating Procedures (SOP) Documentation: Be responsible for the meticulous creation, maintenance, and continuous improvement of comprehensive documentation, including detailed Standard Operating Procedures (SOPs), knowledge base articles, runbooks, and system architecture documentation to ensure operational consistency and facilitate efficient knowledge transfer. • Business Systems Ownership: Manage, optimize, and improve the performance, reliability, and security of HBH's core business systems and operational technology stack. • Strategic Solutions Development: Partner with various business units to develop, implement, and support innovative technology solutions.

United States
$85K - $100K / year
Job Closed
Resource Innovations logo

Market Engagement Lead – Business Analyst

Resource Innovations

A women-led clean energy solutions company, ranked #10 in the energy category on the 2022 Inc. 5000 list.

Business Analyst144 days ago
OtherRemoteTeam 201-500H1B Sponsor

• Support overall program operations across the California SBE portfolio. • Ensure accurate client invoicing, subcontractor accruals, administrative reporting, and program data analysis. • Develop and implement process improvement initiatives to enhance operational efficiency. • Identify, track, and monitor goal progress and manage leads from multiple outreach channels within program databases. • Collaborate with cross-functional teams to ensure accurate and timely project data uploads. • Respond promptly and professionally to inquiries from customers and client representatives. • Engage with internal teams, subcontractors, clients, and stakeholders to understand needs and support program success. • Lead assigned projects by clarifying objectives, asking thoughtful questions, and delivering well-developed solutions within established timelines. • Other duties as assigned.

California
$90K - $110K / year
Job Closed

Senior Claims Business Process Analyst

UnitedHealth Group

UnitedHealth Group is a healthcare and well-being company that’s dedicated to improving the health outcomes of millions around the world. We are comprised of

Business Analyst144 days ago

This position is National Remote. You’ll enjoy the flexibility to telecommute* from anywhere within the U.S. as you take on some tough challenges. For all hires in Minneapolis, Virginia, Maryland, or Washington, D.C. area, you will be required to work in the office for a minimum of four (4) days per week. At UnitedHealthcare, we’re simplifying the health care experience, creating healthier communities and removing barriers to quality care. The work you do here impacts the lives of millions of people for the better. Come build the health care system of tomorrow, making it more responsive, affordable and optimized. Ready to make a difference? Join us to start Caring. Connecting. Growing together Senior Claims Business Process Analyst: This position will be assigned to ClearHealth Strategies’ Independent Dispute Resolution (“IDR”) team. You will work with the IDR team in a quasi-legal process to assist in the review of disputes, eligibility analysis, and preparation of arbitration briefs in support of ClearHealth’s compliance with the federal No Surprises Act and state surprise billing laws. Using available state and federal guidelines, you will be an essential contributor throughout the IDR process, with focus on briefing and submission of documentation to an independent arbiter. You will be expected to cogently respond to requests from CMS, independent arbiters, providers, clients, management, and other individuals throughout the day. Candidate should have the ability to work independently and follow defined standards and procedures with efficiency and accuracy. This position is full-time (40 hours/week) Monday - Friday. Employees are required to work an 8-hour shift schedule during our normal business hours of 8:00 am - 5:00 pm depending local time zone. It may be necessary, given the business need, to work occasional overtime. Primary Responsibilities: - Prepare arbitration briefs - Respond to inquiries from CMS, arbiters, providers, clients, and ClearHealth management - Identify issues, analyze EOBs and claims information, apply critical thinking skills to formulate plan of action, and resolve issues independently - Triage complex issues to management - Manage multiple priorities in a time sensitive manner - Work in fast-paced, high-volume environment with quick turnaround time - Communicate effectively utilizing solid business writing skills - Prioritize and manage workload to meet deadlines, goals, and objectives - Collaborate with coworkers in cohesive team environment - Ready to work, ready to learn mindset - Integrity, accountability, and ability to maintain confidentiality You’ll be rewarded and recognized for your performance in an environment that will challenge you and give you clear direction on what it takes to succeed in your role as well as provide development for other roles you may be interested in. Required Qualifications: - High School Diploma / GED OR equivalent work experience - Must be 18 years of age OR older - 2 + years of legal experience either in a law firm or in-house legal department. - Experience ensuring compliance with HIPAA privacy and security regulations - Ability to work full-time between 8:00 am - 5:00 pm local time, including the flexibility to work occasional overtime given the business need Preferred Qualifications: - 1+ years of experience in the federal No Surprises Act (NSA) and/or state surprise billing disputes - Insurance claims, medical billing and/or health insurance industry experience - Experience in Personal injury litigation - Knowledge of medical claims process Telecommuting Requirements: - Ability to keep all company sensitive documents secure (if applicable) - Required to have a dedicated work area established that is separated from other living areas and provides information privacy. - Must live in a location that can receive a UnitedHealth Group approved high-speed internet connection or leverage an existing high-speed internet service. *All employees working remotely will be required to adhere to UnitedHealth Group’s Telecommuter Policy. Pay is based on several factors including but not limited to local labor markets, education, work experience, certifications, etc. In addition to your salary, we offer benefits such as, a comprehensive benefits package, incentive and recognition programs, equity stock purchase and 401k contribution (all benefits are subject to eligibility requirements). No matter where or when you begin a career with us, you’ll find a far-reaching choice of benefits and incentives. The salary for this role will range from $23.89 - $42.69 per hour based on full-time employment. We comply with all minimum wage laws as applicable. Application Deadline: This will be posted for a minimum of 2 business days or until a sufficient candidate pool has been collected. Job posting may come down early due to volume of applicants. At UnitedHealth Group, our mission is to help people live healthier lives and make the health system work better for everyone. We believe everyone–of every race, gender, sexuality, age, location, and income–deserves the opportunity to live their healthiest life. Today, however, there are still far too many barriers to good health which are disproportionately experienced by people of color, historically marginalized groups, and those with lower incomes. We are committed to mitigating our impact on the environment and enabling and delivering equitable care that addresses health disparities and improves health outcomes — an enterprise priority reflected in our mission. UnitedHealth Group is an Equal Employment Opportunity employer under applicable law and qualified applicants will receive consideration for employment without regard to race, national origin, religion, age, color, sex, sexual orientation, gender identity, disability, or protected veteran status, or any other characteristic protected by local, state, or federal laws, rules, or regulations. UnitedHealth Group is a drug-free workplace. Candidates are required to pass a drug test before beginning employment.

United States
Job Closed
IntellaTriage logo

Remote Nurse Triage RN PT 5p-11p wkday & 8a-4p/2p-10p Sat & Sun

IntellaTriage

Transform your after-hours care strategy to reduce nurse burnout and improve patient experience

Business Analyst144 days ago
OtherRemoteTeam 51-200H1B No Sponsor

IntellaTriage continues to GROW! IntellaTriage Nurses enjoy the benefits of working from home, providing care, without the stress and expense of commuting each day! **MUST have or be willing to obtain a Compact RN license **MUST live in/work from a Compact US state **Minimum of 2 years as a Nurse **Minimum of 1 year of experience in a fast-paced environment (i.e. ED, Critical Care, Surgical Services, Med/Surg, etc.) **Must have high speed internet **Must be tech savvy, enjoy a fast-paced environment, and have no concerns typing **Must be available to work 2 out of every 3 weekends & 1 weekday per week. > 3 shifts per 2 week pay period Mon-Fri, rotating 5p-11p CST > 2 of every 3 weekend rotation (Sat & Sun) rotating 8a-4p/ 2p-10p Our Nurse Advice Line Nurses: - Have proven experience in a fast-paced, critical-thinking environment; ED, Critical Care, Surgical Services, etc. - Work a minimum of 2-3 shift per week (Mon-Fri). - Preferred scheduling for their weekday requirements. - Work 2 weekends or every 3 weeks, both Saturday and Sunday on those weekends with rotating times. (For example: weekend 1: work, weekend 2: work, weekend 3: off) - Train for 3 weeks. First week is Monday-Thursday 9a-6p CST. Remaining two weeks training will be dependent upon preceptor availability but will likely be an evening shift. - Must have a compact license and live in that compact state. (no states with pending legislation or future implementation dates are considered current compacts) What is important to know? We are growing and excited to be able to support our clients’ nursing staffs in the field who need time to focus on work-life balance, as well, while being able to trust that we are there to support them and their patients during nights and weekends! - Patient care is #1. We do not have call quotas. We employ the best nurses to provide the best care. - When our patients or their families reach our triage line, they immediately speak directly with a nurse. - We do not have PRN positions. - We are super busy. If you like fast-paced roles, keep reading… - Any nurse may pick up additional shifts, if shifts are available for the clients’ they are trained to support. - We will provide you with a laptop and headset. - Nurses are required to provide their own high-speed internet (only fiberoptic or coaxial cable internet is compatible with our remote call center technology). - Our laptop is required to be directly connected to your modem. Working through Wi-Fi is not compatible with our systems. The calls will drop. - It is essential to have a home office or quiet space free from noise or distractions in your home (Privacy/HIPAA compliant space is required). - Training is provided remotely and is paid; no travel is required in this role. - MUST be able to follow instructions (verbal and written) and be comfortable with technology (tech savvy). - Must remain in good standing and ensure their home state license remains active. - IntellaTriage will cover the cost of non-compact state licensure based on the client(s) that are assigned for support. - All nurses must have a compact license and reside/work in that state. - Shift prep is a minimum clock-in of 30 minutes prior to taking calls; this is paid time to prepare. - Once calls roll to the next team/shift, our nurses remain clocked in and complete any remaining charting before leaving for the day. This may take 30 minutes or this may take 2 hours. It depends on the pace of the calls received during that shift and the pace of your ability to quickly navigate technology and type. Sound exciting to you? Then… put those days on the floor and that commute or hours on the road between patients’ homes behind you! Our nurses enjoy working from their own home office; no more purchasing scrubs, expensive takeout, and the large gas bill along with extra wear-and-tear on your vehicle. Most importantly, working remotely enables you to spend more time with those you love!

Texas
Job Closed