Regulatory Operations Analyst III

  • Company:
    centene corporation
  • Location:
  • Salary:
    negotiable / month
  • Job type:
  • Posted:
    7 hours ago
  • Category:

Position Purpose: Performs policy research and issue advocacy. Guide special projects; provide regulatory interpretation; perform reporting; and assist in the development of and implementation of auditing and monitoring strategies. Ability to work independently on tasks. * In depth knowledge of Commercial/Marketplace health products, procedures, and state insurance regulations * Update existing EOC/documentation * Review SOBs/SBCs for accuracy * Maintain internal filing trackers to ensure timely submissions * Respond to external requests for information required by the organization for its regulatory filings. * Participate in the creation of COA application submissions for new states * Communicate assessments of CMS objections with Corporate Department partners for the purpose of crafting appropriate responses * Communicate state and federal requirements to internal and external clients * Develop and spearhead new projects with a focus on communications, workflow, and quality initiatives * Assist in developing junior employees and maintain/update training materials * Coordinate/attend cross-departmental meetings as department representative and report back to management team * May attend external conferences and seminars to evaluate industry trends and training materials * Monitor pending legislation and regulations affecting Centene’s commercial product in high risk states * Analyze and interpret proposed or enacted legislation and communicate out to impacted departments * Maintain database and other reference materials related to legislative and regulatory issues and compliance * Assist health plans in managing relationships with regulatory agencies and seek to resolve policy issues which may negatively impact service to members * Conduct research projects to analyze, interpret and disseminate guidance on legal, contractual and regulatory requirements for assigned states Education/Experience: * Bachelors degree, preferably in Business, Communications, Healthcare, Political Science/ Pre-Law, MA or JD or 3 years of regulatory experience including policy analysis and/ or product filings (CMS and/ or State DOI). * Experience preferred in commercial health insurance. * Solid communication skills (written and verbal). * Experience analyzing legislation and/or regulations and conveying findings preferred. * Understanding of the policy issues impacting the healthcare sector * Strong Microsoft Office skills, including PowerPoint, Excel, and Word. 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.#06022021