Regulatory Operations Business Analyst III – Healthcare
Centene Corporation
full-time
Posted on:
Location Type: Remote
Location: Arizona • Florida • United States
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Salary
💰 $70,100 - $126,200 per year
About the role
- Perform or assist with regulatory filings for medium/high risk states
- Completes Qualified Health Plans (QHP) federal and/or state required application templates
- Guides and conducts special projects; reviews and provides interpretation of application instructions from regulatory agencies
- Assists in the development of and implementation of auditing and monitoring strategies
- Performs root cause analysis to inform continuous improvement
- Oversees and prepares Qualified Health Plan templates and/or formal regulatory filing documents
- Audits QHP documents for high-risk states ensuring compliance and accuracy
- Actively manages and collaborates with Sources of Truth (SOT) document owners
- Attends and represents their Regulatory Operations team in meetings
- Analyzes proposed and/or enacted federal and state legislation and/or regulatory orders
- Communicates impacts and/or risks related to their Regulatory Operations team
- Leads implementation of passed legislation or new regulations impacting Qualified Health Plan (QHP)
- Takes ownership of team activities for the maintenance, implementation and continuous improvement of department policies, procedures, and work processes
- Assists with managing relationships with regulatory agencies
- Leads onboarding of new employees and training of analysts on essential job duties
- Coordinates and leads projects internal to the department
Requirements
- Bachelor's Degree in Business, Communications, Health Care, Political Science or equivalent experience
- 4+ years business process or data analysis experience in health insurance, legal, compliance or related area
- Experience in commercial health insurance and/or behavioral health managed care preferred
- Experience drafting and auditing filing documentation (Summary of Benefit Coverage, Schedule of Benefits, etc.) or QHP Templates (Plans and Benefit, Pharmacy, Crosswalk, etc.) preferred
- Experience auditing database or QHP filing documentation preferred
- Knowledge of SERFF and/or HIOS systems preferred
- Proficient Microsoft Excel and Microsoft Word experience
- Adobe Pro experience
- Experience with medical insurance and/or QHP plans, Marketplace benefits, benefit cost-share structure and/or or experience auditing Marketplace SOBs and SBC forms.
Benefits
- competitive pay
- 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 & Tools
regulatory filingsQualified Health Plans (QHP)auditingroot cause analysisdata analysisdrafting documentationauditing filing documentationcompliancebusiness process analysisimplementation of regulations
Soft Skills
communicationcollaborationleadershipproject managementtrainingownershipcontinuous improvementrelationship management