- Lead Government Programs support for Exchange operations, including claims adjudication, regulatory reporting, and audit support.
- Oversee day-to-day operational performance for Exchange programs, ensuring alignment with contractual and regulatory requirements.
- Lead the interpretation, implementation, and monitoring of federal and state regulatory requirements.
- Collaborate cross-functionally with internal SMEs to assess regulatory impacts and ensure timely implementation of changes.
- Design, document, and scale operational processes that enable accurate, compliant, and efficient service delivery.
- Define business and system requirements to support compliant claims processing and reporting.
- Support internal and external audits by federal and state agencies.
- Monitor operations to identify and resolve issues through root cause analysis and corrective actions.
Project ManagementData AnalysisCompliance