Regulatory Operations Business Analyst III

Centene Corporation

. Perform or assist with regulatory filings for medium/high risk states seeking annual approval for individual commercial marketplace products .

Posted 10/28/2026full-timeRemote • Missouri • United StatesMid-LevelSenior💰 $70,100 - $126,200 per yearWebsite

Core Competencies

Role fit

Core Competencies

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Demonstrates expertise in regulatory filings and compliance within the health insurance sector, with a strong focus on Qualified Health Plans (QHP) and auditing processes. Capable of leading projects, analyzing legislation, and collaborating across departments to ensure adherence to regulatory standards.

Highest-signal resume keywords

Regulatory FilingsQualified Health Plans (QHP)SERFF and HIOS SystemsBusiness Process AnalysisCompliance Auditing

ATS Keywords

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Applicant Tracking System Keywords

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Hard Skills

Regulatory ComplianceData AnalysisDocument DraftingRoot Cause AnalysisAuditingLegislation AnalysisContinuous ImprovementProject ManagementTraining DevelopmentPolicy Implementation

Soft Skills

CollaborationLeadershipCommunicationProblem-SolvingAnalytical Thinking

Industry Keywords

Health InsuranceBehavioral Health Managed CareDepartment of Insurance (DOI)Centers for Medicare & Medicaid Services (CMS)Qualified Health Plans (QHP)Filing DocumentationCompliance StandardsBusiness ProcessHealth CarePolitical Science

About the role

Key responsibilities & impact

Perform or assist with regulatory filings for medium/high risk states seeking annual approval for individual commercial marketplace products
Complete Qualified Health Plans (QHP) federal and/or state application templates and documents
Guide and conduct special projects
Review and interpret application instructions from regulatory agencies such as DOI and CMS
Assist in developing and implementing auditing and monitoring strategies
Perform root cause analysis for continuous improvement and special project development
Prepare QHP templates and formal regulatory filing documents for HIOS and SERFF filings
Audit QHP documents for compliance, accuracy, and alignment with product intent
Manage and collaborate with Sources of Truth document owners on QHP filing templates and policy forms
Participate in cross-functional meetings and lead meetings as needed
Analyze legislation and regulatory orders and communicate impacts and risks
Lead implementation of legislation and regulations affecting QHP work
Coordinate maintenance, implementation, and continuous improvement of department policies, procedures, and work processes
Assist with regulatory agency relationships involving DOI and CMS
Lead onboarding and training of analysts and maintain training materials
Coordinate and lead internal departmental projects as a subject matter expert
Attend external and/or virtual conferences and seminars to evaluate industry trends
Perform other duties as assigned and comply with policies and standards

Requirements

What you’ll need

Bachelor's Degree Business, Communications, Health Care, Political Science or equivalent experience required
4+ years business process or data analysis experience in health insurance, legal, compliance or related area required
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
Must be authorized to work in the U.S. without the need for employment-based visa sponsorship now or in the future
Sponsorship and future sponsorship are not available, including employment-based visa types H-1B, L-1, O-1, H-1B1, F-1, J-1, OPT, or CPT

Benefits

Comp & perks

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
Additional forms of incentives may be included in total compensation