Role OverviewAnkura is seeking a Senior Associate to support client engagements involving compliance, operational, and regulatory matters across Medicare Advantage, Medicaid managed care, and Affordable Care Act programs.
The Senior Associate will conduct regulatory research; analyze health plan data, documentation, policies, and operational processes; and develop findings, workpapers, reports, presentations, and other client deliverables. The successful candidate will understand how CMS guidance, state contractual requirements, and other regulatory expectations translate into day-to-day health plan operations.
Responsibilities- Conduct research and analysis of federal and state regulatory requirements applicable to Medicare Advantage, Medicaid managed care, and Affordable Care Act programs.
- Interpret CMS guidance, state Medicaid contracts, regulatory communications, and other requirements to evaluate their impact on health plan operations.
- Review health plan policies, procedures, reports, data, operational documentation, and other supporting materials to assess compliance with applicable requirements.
- Analyze regulatory and operational issues, identify potential gaps or areas of risk, and communicate findings clearly to engagement leadership.
- Develop clear, accurate, and well-supported workpapers, findings, reports, presentations, and other client deliverables.
- Take ownership of defined project workstreams, including coordinating assigned activities, monitoring progress, and completing deliverables within established timelines.
- Work with Project Managers and other engagement leaders to understand client concerns, define project objectives, and develop effective work plans.
- Apply structured problem-solving and critical-thinking skills to complex regulatory, compliance, and operational questions.
- Communicate project updates, emerging issues, and findings to engagement leadership in a timely manner.
- Collaborate effectively with colleagues and client stakeholders to build and maintain strong working relationships.
- Review and provide guidance on work completed by junior team members, as appropriate.
- Support the successful completion of high-quality client deliverables within the desired timeframe.
- Contribute to practice development, internal knowledge sharing, and the continued development of tools, methodologies, and service offerings.
- Maintain the confidentiality of client information and understand the importance of privileged and confidential communications.
Qualifications- Bachelor’s degree from an accredited college or university.
- Approximately three to five years of relevant experience in health plan compliance, regulatory affairs, health plan operations, consulting, or a related field.
- Experience working with Medicare Advantage, Medicaid managed care, Affordable Care Act programs, or other government-sponsored health care programs.
- Working knowledge of CMS guidance, state Medicaid contractual requirements, and the operational processes used by health plans to implement regulatory requirements.
- Experience conducting regulatory research and translating complex requirements into practical operational considerations.
- Experience analyzing health plan data, policies, procedures, documentation, or operational processes.
- Strong analytical, critical-thinking, and problem-solving skills.
- Demonstrated ability to develop clear, concise, and well-supported written analyses and client deliverables.
- Excellent written and verbal communication skills.
- Ability to manage multiple assignments, establish priorities, and meet deadlines in a client-service environment.
- Ability to work effectively both independently and as part of a collaborative engagement team.
- Experience supporting or guiding junior team members is preferred.
- Proficiency in Microsoft Excel, Word, and PowerPoint, including the ability to develop reports, workpapers, analyses, and presentations.
- Willingness to travel based on client and engagement needs.
Preferred Qualifications- Consulting or professional services experience.
- Experience assessing health plan compliance with regulatory or contractual requirements.
- Experience with compliance audits, operational reviews, risk assessments, corrective action plans, or regulatory readiness activities.
- Familiarity with multiple functional areas of health plan operations.
- Experience interacting directly with clients or senior internal stakeholders.
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