Regulatory Operations Business Analyst III
New
C
CenteneHealth insurance
Fully remote within the continental United StatesFull-TimeMiddle
Salary70,100 - 126,200 USD per year
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Job Details
- Experience
- 4+ years business process or data analysis experience in health insurance, legal, compliance or related area required.
- Required Skills
- Data Analysis
Requirements
- Bachelor's degree in Business, Communications, Health Care, Political Science, or equivalent experience.
- At least 4 years of business process or data analysis experience in health insurance, legal, compliance, or a related area.
- Commercial health insurance or behavioral health managed care experience is preferred.
- Experience drafting and auditing filing documentation, such as Summary of Benefit Coverage or Schedule of Benefits, is preferred.
- Experience with Qualified Health Plan templates, including Plans and Benefit, Pharmacy, or Crosswalk templates, is preferred.
- Experience auditing databases or QHP filing documentation is preferred.
- Knowledge of SERFF and/or HIOS systems is preferred.
Responsibilities
- Prepare Qualified Health Plan templates and formal regulatory filing documents for individual commercial marketplace health plans.
- Audit QHP documents for accuracy, compliance, and alignment with product intent.
- Manage collaboration with Sources of Truth document owners and audit complex data inputs across filing documents.
- Represent Regulatory Operations in cross-functional meetings and lead meetings as needed.
- Analyze proposed or enacted legislation and regulatory orders, and communicate their impacts and risks.
- Lead implementation of legislation or regulations affecting QHP work, policy forms, and filing templates.
- Coordinate maintenance and continuous improvement of department policies, procedures, and work processes.
- Coordinate department projects as a subject matter expert and lead analyst onboarding and training.
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