Regulatory Operations Analyst III (Remote)

05 May 2024

Vacancy expired!

You could be the one who changes everything for our 26 million members. Centene is transforming the health of our communities, one person at a time. As a diversified, national organization, you’ll have access to competitive benefits including a fresh perspective on workplace flexibility.Position Purpose: Performs or assists with regulatory filings, seeking approval of commercial products for the commercial markets, and/or performs policy research and issue advocacy. Guides special projects; provides regulatory interpretation; and assists in the development of and implementation of auditing and monitoring strategies. Responsible for creation of QHP templates and/or member policy documents, including Evidence of Coverage and schedules, for commercial products for high-risk states. Serves as the business owner responsible for working with IT on system enhancements and/or fixes to the product benefit database. Owns the preparation and filing for new state entry and new product development.In depth knowledge of health products, procedures, and state insurance regulationsPerform regulatory filings in SERFF and HIOS for high risk statesUpdate existing EOC/documentationPrepare QHP templates needed for filingsReview SOBs/SBCs for accuracyMaintain internal filing trackers to ensure timely submissionsRespond to external requests for information required by the organization for its regulatory filings.Participate in the creation of COA application submissions for new statesCommunicate assessments of CMS objections with Corporate Department partners for the purpose of crafting appropriate responsesCommunicate state and federal requirements to internal and external clientsDevelop and spearhead new projects with a focus on communications, workflow, and quality initiativesAssist in developing junior employees and maintain/update training materialsCoordinate/attend cross-departmental meetings as department representative and report back to management teamMay attend external conferences and seminars to evaluate industry trends and training materialsMonitor pending legislation and regulations affecting Centene’s commercial product in high risk statesAnalyze and interpret proposed or enacted legislation and communicate out to impacted departmentsMaintain database and other reference materials related to legislative and regulatory issues and complianceAssist health plans in managing relationships with regulatory agencies and seek to resolve policy issues which may negatively impact service to membersConduct research projects to analyze, interpret and disseminate guidance on legal, contractual and regulatory requirements for assigned statesEducation/Experience:

Bachelor’s degree in Business, Communications, Healthcare, Political Science/ Pre-Law or equivalent experience. 4+ years of experience in health insurance, legal, or compliance required. Experience in commercial health insurance and/or behavioral health managed care. Knowledge of SERFF and HIOS preferred. Experience drafting and auditing policy documentation or QHP Templates preferred. Experience auditing database or documentation preferred.Our Comprehensive Benefits Package: Flexible work solutions including remote options, hybrid work schedules and dress flexibility, Competitive pay, Paid time off including holidays, Health insurance coverage for you and your dependents, 401(k) and stock purchase plans, Tuition reimbursement and best-in-class training and development.Centene is an equal opportunity employer that is committed to diversity, and values the ways in which we are different. All qualified applicants will receive consideration for employment without regard to race, color, religion, sex, sexual orientation, gender identity, national origin, disability, veteran status, or other characteristic protected by applicable law.TITLE: Regulatory Operations Analyst III (Remote)LOCATION: Various, IndianaREQNUMBER: 1423562

Full-time
  • ID: #49869396
  • State: Indiana Indianapolis 46201 Indianapolis USA
  • City: Indianapolis
  • Salary: USD TBD TBD
  • Showed: 2023-05-05
  • Deadline: 2023-07-05
  • Category: Et cetera