Regulatory Operations Filing Analyst II
Remote-IL, United States
You could be the one who changes everything for our 28 million members. Centene is transforming the health of our communities, one person at a time. As a diversified, national organization, you’ll have access to competitive benefits including a fresh perspective on workplace flexibility.
Applicants for this job have the flexibility to work remote from home anywhere in the Continental United States.
Position Purpose: Responsible for the timely, consistent, and accurate communication of state and federal regulatory updates related to the regulatory filing of commercial plans. Prepares, organizes, and submits the annual QHP and Off-Exchange product filings for assigned states using Health Insurance Oversight System (HIOS) and System for Electronic Rates & Forms Filing (SERFF).
- Monitors regulatory guidance and requirements affecting Centene’s commercial products. Analyzes, interprets, summarizes and distributes regulatory filing guidance to impacted cross-functional departments. Provides guidance to business to help them understand regulatory filing requirements and timelines.
- Executes timely and accurate formal regulatory filings, including the annual QHP and off-exchange product filings, seeking approval of our commercial health products within Health Insurance Oversight System (HIOS) and System for Electronic Rates & Forms Filing (SERFF) for assigned states ensuring deliverables spanning across multiple departments are received and appropriately filed.
- Acts as the primary contact between Regulators and the company, supporting communication during the filing season as needed. Manages relationship with regulatory agencies (Department of Insurance and Centers for Medicare & Medicaid Services (CMS)) related to the commercial filings. Leads responses to DOI objections and CMS correction communications for assigned states. Partners closely with health plans in managing relationships with regulatory agencies, including state regulators and State Based Exchanges.
- Conducts assigned special projects and maintains multiple critical trackers related to filing work. Should have the ability to understand the needs of internal and cross-functional departments and communicate those needs effectively at the appropriate level of detail for the audience.
- Performs regulatory filing research to aid in the development of new products and initiatives for the Enterprise related to commercial products. Responsibility for understanding regulations and business needs for multiple states, as well as federal regulations pertaining to the commercial health insurance market.
- Interprets and distributes data collected throughout the filing season to aid in proactively updating processes for ongoing improvement across multiple departments.
- Creates and maintains a deliverables chart which outlines all required documents needed for state specific filings. Audits trackers and deliverable for assigned states to ensure consistency …
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Holidays Must be located in the continental United States
Benefits/PerksCompetitive benefits Competitive pay Comprehensive benefits Comprehensive benefits package Flexible approach Health insurance Holidays Paid Time Off Stock purchase Stock purchase plans Tuition reimbursement Workplace flexibility
Tasks- Develop
- Manage relationships with regulators
- Prepare and submit filings
Access Audits Benefits Business CMS Communication Communications Cross-functional Communication Data analysis Education Flexibility Healthcare Health Insurance Insurance Medicaid Medicare Operations Procedures Project Management Regulatory Regulatory Filing Regulatory filings Regulatory Guidance Research SERFF Teams
Experience3 years
EducationAS Bachelor's Bachelor's degree Business Communications Education Equivalent Equivalent experience Healthcare Insurance Political science Pre-law
TimezonesAmerica/Anchorage America/Chicago America/Denver America/Los_Angeles America/New_York Pacific/Honolulu UTC-10 UTC-5 UTC-6 UTC-7 UTC-8 UTC-9