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Regulatory Operations Business Analyst IV
Centene Corporation. Complete Qualified Health Plans (QHP) federal and/or state application templates and documents, including policy forms for individual commercial marketplace products .
About the role
Key responsibilities & impact- Complete Qualified Health Plans (QHP) federal and/or state application templates and documents, including policy forms for individual commercial marketplace products
- Review and interpret application instructions from Departments of Insurance and CMS
- Develop and implement auditing and monitoring strategies for high-risk states
- Prepare and oversee QHP templates and regulatory filing documents for HIOS and SERFF filings
- Ensure quality control, regulatory compliance, organizational standards, and alignment with internal operations, products, and financial arrangements
- Mentor and oversee junior team members and support their professional growth
- Audit QHP documents for low-, medium-, and high-risk states and coordinate department audits
- Develop and implement continuous improvement, build, audit, and quality initiative strategies
- Lead management, creation, auditing, and maintenance of Sources of Truth documents
- Represent Regulatory Operations in cross-functional meetings and lead data reviews
- Analyze federal and state legislation and regulatory orders and determine impacts and risks
- Lead implementation of new regulations and legislation, including updates to policy and filing documents
- Lead onboarding and training of analysts and maintain training materials
- Coordinate and lead internal and cross-functional projects as a subject matter expert
- Attend external and virtual conferences and seminars to evaluate industry trends
- Perform other duties as assigned
Requirements
What you’ll need- Bachelor's Degree in Business, Communications, Health Care, Political Science or equivalent experience required
- Master's Degree in a related field preferred
- 6+ 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, QHP Templates or related area preferred
- Experience auditing database or QHP filing documentation preferred
- Experience analyzing legislation and/or regulations and conveying findings preferred
- Knowledge of SERFF and HIOS systems preferred
- Must be authorized to work in the U.S. without employment-based visa sponsorship now or in the future
- Must comply with company policies and standards
Benefits
Comp & perks- Health insurance
- 401K plan
- 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
- Equal opportunity employer committed to diversity