Regulatory Operations Lead

GENERAL DESCRIPTION: Responsible for ensuring the seamless transition, ongoing compliance, and continuous improvement of regulatory requirements from project implementation to business-as-usual operations. Acts as a key operational expert, partnering across business units to maintain audit readiness, manage regulatory changes, and uphold clear ownership of regulatory processes impacting multiple departments. ESSENTIAL FUNCTIONS: • Lead the assessment and operationalization of new and existing regulatory changes (federal and state), determining whether updates require minor process adjustments or initiation of new projects with the Project Management Operations (PMO), and collaborate on major regulatory initiatives to ensure structured execution and operational readiness. • Oversee compliance management by monitoring control effectiveness, maintaining audit evidence, assessing processes, documentation, metrics, and data sets to identify operational and compliance risks or gaps, and coordinating the development and implementation of timely remediation activities with business units to ensure continuous audit readiness. • Develop, update, and maintain comprehensive regulatory documentation, including Standard Operating Procedures (SOPs), process maps, control frameworks, and audit logs, ensuring version control, accessibility, and alignment with current regulatory requirements. • Execute operational compliance activities related to key regulations such as Transparency, No Surprises Act, Interoperability, Provider Relief Fund Management and Monitoring Information System (PRMMIS), Mental Health, and Multilanguage requirements, supporting business units in understanding their compliance roles and control expectations. • Partner cross-functionally to maintain sustainable regulatory processes, supporting business units in operationalizing regulatory obligations and driving continuous improvements to processes, workflows, controls, reporting, and documentation to enhance efficiency and reduce risk. • Works alongside Compliance, Legal, and Business SMEs to interpret requirements and translate them into actionable operational expectations. • Prepare and support internal and external regulatory audits by compiling necessary documentation, maintaining evidence repositories, and managing follow-up actions to demonstrate ongoing compliance. • Conduct regulatory impact analyses to evaluate operational, financial, and technological implications of new rules and guidance, recommending action plans and resource needs. • Lead periodic assessments to validate the effectiveness of implemented controls and the execution of regulatory requirements • Support change-management activities for regulatory implementations, including communications, readiness assessments, stakeholder coordination, and post-implementation reviews. • Supervises, monitors, trains, evaluates, and corrects personnel among others to comply with his/her role as a supervisor, to assure that his/her personnel fulfill their work plan and comply with their essential functions and that they behave following the policies, standards, norms, and procedures of the Company. • Must comply fully and consistently with all company policies and procedures, with local and federal laws as well as with the regulations applicable to our Industry, to maintain appropriate business and employment practices. • May carry out other duties and responsibilities as assigned, according to the requirements of education and experience contained in this document. MINIMUM QUALIFICATIONS Education and Experience: Bachelor’s Degree in Business Administration, Industrial Engineering, Health Administration, Compliance, or related fields. At least five (5) years of experience in regulatory compliance, operations, PMO/governance, and audit. Experience working in healthcare, insurance, or government-regulated environments, and supporting regulatory audits or compliance initiatives is preferred. “Proven experience may be replaced by previously established requirements.” Certifications / Licenses: A valid Six Sigma Green Belt or Lean Six Sigma Certification is preferred. Other: Knowledge of regulatory requirements, operational processes, and control frameworks. Knowledge of project management principles related to regulatory initiatives and operational transitions. Languages: Spanish – Advanced (comprehensive, writing, and verbal) English – Advanced (comprehensive, writing, and verbal)