Regulatory Operations Analyst III – Medicaid

🕒 4 dias atrás

🌲 Oregon – Remoto

🌲 Oregon – Remote

💵 $70.100 - $126.200 / ano

⏰ Tempo Integral

🟡 Pleno

🟠 Sênior

⚙️ Operações

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Centene Corporation

SiteLinkedInTodas as Vagas

10.000+ funcionários

Fundada em 1984

🛡️ Seguros

💼 Consultoria

🏥 Saúde

Insurance • Consulting • Healthcare

Centene Corporation é uma provedora líder de serviços de saúde patrocinados pelo governo, especializada em oferecer soluções de saúde acessíveis e de alta qualidade. Há mais de 40 anos, a Centene tem se dedicado a transformar a saúde das comunidades, ampliando o acesso a Medicaid, Medicare e ao Health Insurance Marketplace, além de atender comunidades militares por meio do programa TRICARE. Como a maior organização de managed care do Medicaid e participante-chave no Marketplace, a Centene enfatiza a entrega de cuidados de saúde com foco local, combinada a parcerias sólidas com organizações sem fins lucrativos para atender às necessidades únicas de seus membros. A Centene também é comprometida com sustentabilidade corporativa e responsabilidade social, priorizando a gestão ambiental e a governança ética para promover o bem-estar das comunidades que atende.

Descrição

• Review, interpret, and summarize proposed and enacted legislation and regulatory updates • Perform state and federal policy research and regulatory change monitoring • Support achievement of formal regulatory approval for assigned products • Identify, analyze, and interpret legislation and communicate findings to impacted departments • Perform independent risk assessments, including impacts to business applications and downstream output • Maintain databases and reference materials related to legislative and regulatory issues and compliance • Lead regulatory interpretation for assigned product rules and regulations • Provide advice to the business as new regulations emerge • Track proposed changes to Oregon Administrative Rules and keep subject matter experts updated • Engage in Rule Advisory Committees and support written feedback submissions to the Oregon Health Authority • Act as business owner for the Regulatory Legislation Implementation process • Support the annual contract restatement process from proposal through finalization and implementation • Monitor contract changes, attend meetings, track implementation status, and escalate risks • Analyze contract amendments throughout the year • Support Oregon Health Plan contractor workgroups, meetings, and Requests for Information • Support monthly Division of Financial Regulation meetings and manage follow-ups and communications • Assess objections related to regulatory interpretation and lead drafting responses to regulators • Partner with cross-functional teams as needed • Comply with all policies and standards • Perform other duties as assigned

🎯 Requisitos

• Bachelor's Degree in Business, Communications, Healthcare, Political Science/Pre-Law or equivalent experience required • 4+ years experience in health insurance, legal, compliance or related field required • Demonstrated ability to build and maintain effective working relationships with state regulators, particularly the Oregon Health Authority (OHA) • Strong technical understanding of Medicaid policy, administrative rules, and regulatory guidance • High level of attention to detail and strong organizational skills • Ability to translate technical regulatory and policy language into clear, plain-language guidance and actionable recommendations • Proven ability to advocate for regulatory clarifications or changes • Strong compliance mindset and experience aligning organizational practices with regulatory and contractual requirements • Experience reviewing regulations and providing interpretation using terms appropriate for the audience preferred • Experience in commercial health insurance and/or behavioral health managed care preferred • Master's Degree in a related field or Juris Doctorate degree may be considered in place of experience preferred • Candidates must be located in the State of Oregon

🏖️ Benefícios

• Competitive pay • Health insurance • 401K • Stock purchase plans • Tuition reimbursement • Paid time off plus holidays • Flexible approach to work with remote, hybrid, field or office work schedules • Additional forms of incentives may be included in total compensation • Equal opportunity employer committed to diversity

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