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Core Competencies
Role fitCore Competencies
Use this summary to align your resume positioning with the role.
Demonstrates expertise in project implementation and compliance within the healthcare sector, particularly with Covered California products. Proficient in analytical activities, regulatory submissions, and cross-functional collaboration to enhance operational efficiency.
Highest-signal resume keywords
Project Implementation SupportRegulatory Compliance KnowledgeHealthcare Analytics ExperienceProficiency in Microsoft OfficeProject Management Software Knowledge
ATS Keywords
Tailor your resumeApplicant Tracking System Keywords
Tip: use these terms in your resume and cover letter to boost ATS matches.
Hard Skills
Project ImplementationRegulatory SubmissionsHealthcare AnalyticsBenefit DesignEnrollment OperationsAnalytical SkillsQuality Assurance ReviewsProcess DevelopmentProject DocumentationCompliance Assessment
Soft Skills
Strong Organizational SkillsCritical ThinkingVerbal CommunicationWritten CommunicationTeam Collaboration
Tools & Technologies
WorkfrontMS ProjectMicrosoft WordMicrosoft ExcelMicrosoft VisioMicrosoft PowerPoint
Industry Keywords
Covered CaliforniaCMSDHCSHealth Plan OperationsRegulatory TemplatesOperational RequirementsProcess FlowsStandard WorkProject ScopesCompliance Gaps
About the role
Key responsibilities & impact- Ensure the Covered California line of business is administered in alignment with compliance and operational requirements
- Support the annual Covered California product renewal and implementation cycle
- Support operational and system enhancement projects
- Support product and project implementation
- Conduct quality assurance reviews for product-owned regulatory templates, member-facing materials, and product documentation
- Support cross-functional product implementation projects involving regulatory compliance, system enhancement, process development, and improvement
- Develop project scopes, goals, deliverables, detailed project plans, and comprehensive project documentation
- Monitor project plans, manage scope and schedule changes, communicate risks, and report or escalate project status and barriers
- Assess policies and standard procedures against new regulations to identify compliance and process gaps
- Define annual product renewal implementation requirements
- Plan and manage regulatory templates, materials, and product documents for submission
- Support cross-functional implementation projects impacting up to three departments
- Facilitate development and documentation of operational and regulatory requirements, process flows, standard work, and business requirements
- Perform analytical activities using initiative and organizational skills
- Perform other duties required to support Health Plan operations and department business needs
Requirements
What you’ll need- A minimum of four (4) years of experience providing analytical and/or project implementation support within a healthcare environment, preferably in support of Covered California products or regulatory operation
- High school diploma or GED
- Experience with health plan product filings and regulatory submissions preferred
- Knowledge of CMS, DHCS, and Covered California requirements preferred
- Experience with benefit design, enrollment operations, or healthcare analytics preferred
- Working knowledge of project management software such as Workfront, MS Project or equivalent preferred
- Strong organizational skills
- Strong critical thinking, verbal and written communication skills
- Demonstrated proficiency in Microsoft Office products: Word, Excel, Visio, and PowerPoint
- Ability to establish and maintain effective working relationships within and outside of the division
- Ability to work well in a team environment and build effective relations with Team Members at all levels
- Detail oriented with exceptional follow-through to track outstanding tasks and ensure timely completion
Benefits
Comp & perks- Competitive salary
- Hybrid schedule
- CalPERS retirement
- State of the art fitness center on-site
- Medical Insurance with Dental and Vision
- Life, short-term, and long-term disability options
- Career advancement opportunities and professional development
- Wellness programs that promote a healthy work-life balance
- Flexible Spending Account – Health Care/Childcare
- 457(b) option with a contribution match
- Paid life insurance for employees
- Pet care insurance
