Centene Corporation · 4 days ago

Regulatory Operations Business Analyst III

Missouri, United States

Full-time

Onsite

Senior Level

$67K/yr - $121K/yr

4+ years exp

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Hospitals and Health Care

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Responsibilities

Oversees and prepares Qualified Health Plan templates and/or formal regulatory filing documents for high-risk states.

Audits Qualified Health Plan documents for high-risk states to ensure compliance and accuracy.

Manages and collaborates with Sources of Truth (SOT) document owners for QHP filing template and policy form development.

Attends and represents the Regulatory Operations team in cross-functional meetings to ensure accuracy of QHP filing documents.

Analyzes proposed federal and state legislation, communicates impacts to Regulatory Operations team, and leads implementation of new regulations.

Coordinates team activities for the maintenance, implementation, and continuous improvement of department policies and procedures.

Assists in managing relationships with regulatory agencies, onboarding new employees, and training analysts.

Leads projects internal to the department, acts as a subject matter expert, and ensures compliance with all policies and standards.

Qualification

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Business process analysisData analysisHealth insuranceLegalComplianceCommercial health insuranceBehavioral health managed careProblem solvingAnalytical thinkingAuditingFiling documentationQHP TemplatesDatabase auditingSERFF knowledgeHIOS systems knowledge

Required

Bachelor's Degree in Business, Communications, Health Care, Political Science or equivalent experience

4+ years business process or data analysis experience in health insurance, legal, or compliance

4+ years experience in commercial health insurance and/or behavioral health managed care

Preferred

4+ years experience drafting and auditing filing documentation (Summary of Benefit Coverage, Schedule of Benefits, etc.) or QHP Templates (Plans and Benefit, Pharmacy, Crosswalk, etc.)

4+ years experience auditing database or QHP filing documentation

4+ years knowledge of SERFF and/or HIOS systems