Compliance Specialist (Healthcare Insurance Regulations)
Company: Novus Group
Location: Pittsburgh
Posted on: February 18, 2026
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Job Description:
Job Description Job Description Compliance Specialist (Hybrid)
Status: Full-Time, Direct Hire – employee of the Company (not a
contract or temporary job) Location: Pittsburgh, PA 15219 Work
Arrangement: Hybrid (Combined Work from Home & In-Office
requirement at the Pittsburgh office) New Hire Salary Range: $34.98
- $41.37 per hour based on match to job requirements and experience
Opportunity to Earn More: After hire, performance-based increases
can be earned Benefits: Health & Wellness: Multiple medical plan
options (HSA/FSA eligible), $0 preventive care Financial Future: A
comprehensive retirement program, some plans have a 50% match on
the first 4% of your contributions. Education: Up to $6,000 per
academic year in tuition assistance for you and your dependents.
Work-Life Balance: A hybrid schedule (home/office), 7 paid
holidays, and up to 5.5 weeks of accrued PTO per year. Extra Perks:
Paid Parental Leave, Student Loan Refinancing, and much more! The
Compliance Specialist is integral to the Corporate Compliance and
Ethics Program. You will work alongside the Compliance Officer and
Committee to ensure our health insurance practices meet federal,
state, and local regulations while mitigating operational risks.
The ideal candidate is a self-motivated professional who thrives in
an independent working environment and takes proactive initiative
in regulatory oversight. Responsibilities Strategic Reporting:
Assist in developing dashboards, metrics, and reports for senior
management and the Board to demonstrate Compliance Program
effectiveness. Risk & Policy Management: Perform regular gap
analyses and risk assessments. Draft, adapt, and review Compliance
policies and procedures to ensure internal operations remain
consistent and accurate. Remediation: Develop and oversee
corrective action plans and remediation protocols to ensure timely
compliance across all departments. Regulatory Liaison: Act as a
representative during regulatory agency reviews, investigations,
and requests for information. Industry Expertise: Keep abreast of
changing industry laws and standards. Communicate contractual
requirements throughout the health plan and research complex
regulatory inquiries. Collaboration: Coordinate with internal
subject matter experts (SMEs) and business teams to support
regulatory product filings, proposal development, and service area
expansions. Training: Support Program Leadership in conducting
annual and ongoing compliance training for staff and applicable
third parties. Qualifications Education: Bachelor’s degree required
. A Juris Doctor (JD) or Master’s degree in a related field is a
plus. Experience: Direct experience conducting compliance
assessments, audits, or risk assessments. Five (5) years of
compliance or legal experience preferred, specifically on the
insurance (payer) side. Pennsylvania-specific regulatory experience
is highly preferred. Knowledge Base: Proficiency in
Medicaid/Medicare Managed Care and various lines of business
(Commercial, CHIP, Marketplace). Expert level experience with
Medicaid and/or Medicare managed care and with the different lines
of business/benefits (i.e., Commercial, Medicaid, CHIP,
Marketplace
Keywords: Novus Group, Altoona , Compliance Specialist (Healthcare Insurance Regulations), Science, Research & Development , Pittsburgh, Pennsylvania
