OpTech · 1 week ago
Health Insurance Product Analyst
United States
Contract
Remote
Mid Level
$32/hr - $32/hr
3+ years expOpTech is seeking an experienced Product Contract Compliance Specialist to support the development, maintenance, and regulatory compliance of health insurance contract language and member materials. This role focuses on Individual <65 and Group products, ensuring compliance with state and federal regulations while collaborating with various internal teams.
ConsultingCyber SecurityRecruiting
Responsibilities
Develop and maintain contract language and member materials including benefit booklets, schedules of benefits, endorsements, and enrollment forms
Support custom options and non-standard benefits for new and renewing large group and Individual <65 products
Review business requirements to assess contract impacts, timelines, and required materials
Translate business needs and legislative requirements into clear, accurate, and legally compliant contract language
Ensure compliance with state, federal, and BCBSA Inter-Plan Program requirements
Update contract materials throughout the product lifecycle for new programs, services, and benefit changes
Create finalized forms, redlines, mockups, and variable/static materials for Contract Automation systems
Support auditing and system testing of contract materials
Track and monitor deliverables to ensure quality, accuracy, and on-time completion
Work closely with Legal, Product Development, Sales, Pharmacy Programs, Rate Administration, Actuarial, and Contract Automation teams
Maintain strong working relationships to meet compliance, regulatory, and project deadlines
Provide consultation and guidance on contract-related questions to internal stakeholders
Maintain and organize contract databases, document libraries, and version control
Coordinate updates to member and group enrollment forms, including the Group Administrative Guide (GGA)
Identify discrepancies, escalate issues, and partner with stakeholders to implement solutions
Support internal mailbox requests from Legal, Sales, Grievance & Appeals, and Critical Inquiries teams
Coordinate member and group mailings, including complex form mapping and address validation
Retrieve and provide contract materials for audits, regulatory exams, and investigations
Develop in-depth knowledge of Individual <65 and Group health insurance products
Provide guidance and training to peers and business partners on contract materials
Support sales partners and external group administrators during group setup and renewals
Contribute to departmental policies, procedures, and SOPs
Identify and implement process improvements to increase efficiency and accuracy
Prepare contract materials for product filings
Coordinate with Legal and Actuarial teams to submit filings to the Office of Insurance Regulation (OIR) and other regulatory bodies
Support stakeholders in resolving filing issues and securing regulatory approvals
Qualification
Required
3–5 years of related experience in health insurance contract compliance, product operations, or regulatory support
2+ years of experience with BCBS products in Individual <65 and Group segments
Strong understanding of state and federal health insurance regulations
Experience supporting product filings and regulatory submissions
Excellent written and verbal communication skills
Strong attention to detail (grammar, spelling, proofreading, punctuation)
Proven ability to multitask and manage multiple priorities in a fast-paced environment
Strong analytical, organizational, and problem-solving skills
Ability to work independently in a remote environment
Experience collaborating with Legal and Sales partners
Proficiency with MS Word, Excel, PowerPoint, SharePoint, and internet-based tools
Knowledge of customer experience and compliance procedures
Preferred
Knowledge of medical terminology, benefit coding, and clinical procedures
Experience with custom and non-standard benefits for large groups
Working knowledge of RBMS, Contract Automation, and Siebel Sales
Project management experience supporting cross-functional initiatives
Benefits
Client-issued equipment provided
Company
OpTech
OpTech is a professional services firm providing IT, engineering, healthcare and financial services to Fortune 500 and Government clients.
201-500 employees
H1B Sponsorship
OpTech has a track record of offering H1B sponsorships. Please note that this does not
guarantee sponsorship for this specific role. Below presents additional info for your
reference. (Data Powered by US Department of Labor)
Distribution of Different Job Fields Receiving Sponsorship
Represents job field similar to this job
Trends of Total Sponsorships
2024 (1)
2023 (1)
2022 (1)
2021 (1)
Funding
Current Stage
Growth StageLeadership Team
Ronia Kruse
President/CEO
Neil W. Monette, Ph.D.
Chief Technology Officer
Recent News
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