Wellfleet · 13 hours ago
Regulatory & Provider Network Filing Analyst
United States
Full-time
Remote
Entry, Mid Level
$60K/yr - $80K/yr
2+ years expWellfleet, a Berkshire Hathaway company, delivers customer-centric accident and health insurance. The Regulatory & Provider Network Filing Analyst is responsible for preparing and submitting student health insurance network filings and reports, ensuring compliance with regulatory requirements and collaborating with stakeholders.
Employee BenefitsHealth CareInsuranceInsurTechLife Insurance
Responsibilities
Serve as a subject matter expert (SME) in provider network regulations, accreditation requirements, network adequacy standards, and other new and existing laws pertaining to provider networks, guiding and advising across various business areas and activities, including internal and external stakeholders
Implement and enforce best practices and policies, ensuring alignment with department and organizational goals
Perform a detailed review of new legal and regulatory guidance to identify and implement any necessary changes
Track regulatory submission deadlines, and proactively coordinate with external and internal stakeholders to prepare filings in advance of deadlines
Oversee network filings and reports from inception to completion, ensuring that all submissions are accurate, well-written, and timely
Regularly monitor open submission to ensure timely and accurate responses to any objections or requests for additional information
Support the review and development of written responses for network submissions and responses to objections, as needed, and validate data to ensure accurate reporting
Ensure all regulatory filings and reporting deadlines are met
Implement and enforce best practices and assist with ad hoc projects to achieve departmental or organizational goals
Collaborate with internal and external stakeholders to perform network oversight, and develop and monitor corrective action plans, as needed
Perform other duties as assigned
Qualification
Required
Bachelor's degree in healthcare administration or related field, and 2+ years of health insurance experience, or a combination of education and experience
Ability to work effectively with internal and external stakeholders
Ability to interpret and apply state and federal laws and regulations
Excellent written communication and interpersonal skills
Strong organizational skills and the ability to manage competing priorities
Proficiency with MS Office products including Outlook, Word and Excel
Demonstrates a strong commitment to compliance and ethics
Self-motivated with the ability to work independently, with very little supervisory direction
Preferred
Compliance and/or network experience
SERFF filing system experience
Familiarity with provider network regulations, accreditation requirements, and NCQA standards
Benefits
Life, health and dental, vision, 401K retirement plan, short- and long-term disability coverage, flexible/dependent care spending account, tuition reimbursement
Company
Wellfleet
Wellfleet is an insurance company that provides accident and health insurance.
201-500 employees
Funding
Current Stage
Growth StageLeadership Team
Kim Adler
Vice President Strategic Partnerships
Philip LaCombe
CIO
Recent News
Coverager - Insurance news and insights
2022-05-25
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