Service Analyst – End User Computing Enablement
Allstate
Contract Development Analyst III
Centene Corporation
full-time
Posted on:
Location Type: Remote
Location: Remote • Kansas, Montana, Ohio, Tennessee • 🇺🇸 United States
Visit company websiteSalary
💰 $68,700 - $123,700 per year
Job Level
Mid-LevelSenior
About the role
- Responsible for creation of member contract documents, including Evidence of Coverage (EOC) and related documents, for commercial products for high risk states.
- Independently performs regulatory and operational research related to EOC and benefit development.
- Conducts risk assessments, including impact to member contract documentation and downstream output.
- Monitors pending legislation and regulations affecting Centene's commercial product in high risk states.
- Provides updates to relevant member contract documents and recommends changes.
- Performs detailed language analysis of the Ambetter/Commercial Evidence of Coverage (EOC) to ensure compliance with State and Federal regulations.
- Leads initiatives related to these activities.
- Drafts and creates alternative language to include in regulatory member materials.
- Conducts research projects to provide guidance on legal, contractual and regulatory requirements for assigned states.
- Seeks to resolve member contract documentation issues that may negatively impact service to members.
- Serves as a Subject Matter Expert with knowledge of health insurance products and regulations.
- Analyzes pending legislation and provides recommendations for changes to member contractual documents.
- Develops and presents communications with alternative viewpoints.
Requirements
- Bachelor's Degree in Business, Communications, Pre-Law or related field or equivalent experience required
- Master's Degree in a related field or Jurisprudence (JD) preferred
- 3+ years regulatory experience including creation of regulatory documentation, policy analysis and product filings (CMS and/or State DOI) required
- 3+ years experience in commercial health insurance or a highly regulated industry required
- 3+ years experience drafting and auditing member contract documentation or related documents.
- Experience analyzing legislation and/or regulations and conveying findings.
- Understanding policy issues impacting the healthcare sector preferred
Benefits
- health insurance
- 401K and stock purchase plans
- tuition reimbursement
- paid time off plus holidays
- flexible approach to work with remote, hybrid, field or office work schedules
Applicant Tracking System Keywords
Tip: use these terms in your resume and cover letter to boost ATS matches.
Hard skills
regulatory documentation creationpolicy analysisproduct filingsmember contract documentation draftinglanguage analysisrisk assessmentlegislative analysiscompliance analysiscontractual requirements researchhealth insurance product knowledge
Soft skills
communicationleadershipproblem-solvingresearchanalytical thinkinginitiativeattention to detailcollaborationrecommendation developmentsubject matter expertise
Certifications
Bachelor's DegreeMaster's DegreeJurisprudence (JD)
