Centene Corporation Regulatory Operations Analyst IV (Remote) in Jefferson City, Missouri
You could be the one who changes everything for our 26 million members. Centene is transforming the health of our communities, one person at a time. As a diversified, national organization, you’ll have access to competitive benefits including a fresh perspective on workplace flexibility.
Position Purpose: Performs and oversees formal regulatory filing submission process, seeking approval of commercial products for the commercial markets, and/or performs and oversees policy research and issue advocacy. Responsible for overseeing the development process (including quality review) for the creation of QHP templates and/or member policy documents, including Evidence of Coverage and schedules, for all commercial products (low-, medium-, high-risk). Serves as the business owner responsible for working with IT on system enhancements and/or fixes to the product benefit database. Leads special projects and large initiatives, representing the department as a subject matter expert in cross-functional forums; provides regulatory interpretation; and develops and implements auditing and quality initiative strategies. Mentors staff in their professional growth and support of Centene business goals.
Reviews, interprets and summarizes proposed and enacted legislation and regulatory updates, and subsequently communicates impact/high risk out to business leads and leadership.
Coordinates, develops, monitors, and lead projects (regulatory or filing) internal to the department and cross-functional business partners, acting as a subject matter expert for the department.
Coordinates, oversees and performs quality assurance audits on department work product, including: regulatory research, filings, member policy documents, projects, communications.
Assists in the development of employee onboarding and training materials, and the continued mentoring of staff members.
Education/Experience: Bachelor’s degree in Business, Communications, Healthcare, Political Science/ Pre-Law or equivalent experience required. Master’s degree preferred. 6+ years of experience in health insurance, legal, or compliance required. Experience in commercial health insurance and/or behavioral health managed care. Experience analyzing legislation and/or regulations and conveying findings. Knowledge of SERFF and HIOS preferred. Experience drafting and auditing policy documentation or QHP Templates preferred. Experience auditing database or documentation preferred. Understanding of the policy issues impacting commercial healthcare sector/health insurance industry, business dynamics in the healthcare marketplace, and how federal and state policy and regulations impacts the industry preferred.
Our Comprehensive Benefits Package: Flexible work solutions including remote options, hybrid work schedules and dress flexibility, Competitive pay, Paid time off including holidays, Health insurance coverage for you and your dependents, 401(k) and stock purchase plans, Tuition reimbursement and best-in-class training and development.
Centene is an equal opportunity employer that is committed to diversity, and values the ways in which we are different. All qualified applicants will receive consideration for employment without regard to race, color, religion, sex, sexual orientation, gender identity, national origin, disability, veteran status, or other characteristic protected by applicable law.
TITLE: Regulatory Operations Analyst IV (Remote)
LOCATION: Various, Missouri
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