Regulatory Operations Analyst – III

🔥 9 hours ago

🐊 Florida, Ohio, +2 more states – Remote

🐊 Florida – Remote 🏈 Ohio – Remote 🚗 Michigan – Remote 🏰 Missouri – Remote

💵 $70.1k - $126.2k / year

⏰ Full Time

🟡 Mid-level

🟠 Senior

⚙️ Operations

👻 Ghost score 0%

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Centene Corporation

WebsiteLinkedInAll Job Openings

10,000+ employees

Founded 1984

🛡️ Insurance

💼 Consulting

🏥 Healthcare

Insurance • Consulting • Healthcare

Centene Corporation is a leading provider of government-sponsored healthcare services, specializing in delivering affordable and high-quality healthcare solutions. For over 40 years, Centene has focused on transforming the health of communities by expanding access to Medicaid, Medicare, and Health Insurance Marketplace services, as well as serving military communities through the TRICARE program. As the largest Medicaid managed care organization and a key participant in the Marketplace, Centene emphasizes localized healthcare delivery combined with strong partnerships with nonprofit organizations to meet the unique needs of its members. Centene is also committed to corporate sustainability and social responsibility, prioritizing environmental stewardship and ethical governance to enhance the well-being of the communities it serves.

📋 Description

• Review, interpret and summarize proposed and enacted legislation and regulatory updates • Perform state and federal policy research and regulatory change monitoring • Identify, analyze and interpret legislation related to assigned products 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 • Analyze and disseminate Commercial/ACA regulatory updates and changes • Lead regulatory interpretation and advise the business as new regulations emerge • Address potential legal, contractual and regulatory issues and determine appropriate solutions • Collaborate across functional areas to lead large projects and initiatives • Represent the department in cross-departmental meetings and escalate matters to management • Support and manage relationships between health plans and state and federal regulatory agencies • Draft responses to external requests for information for regulatory filings and policy needs • Understand regulations and business needs across multiple states and federal commercial health insurance regulations • Lead drafting of responses to regulators related to commercial/ACA filings • Support regulatory guardrails for new state entry and product development • Work with Legal on COA application materials and submissions for new states and products • Assist with developing and mentoring junior employees and revising training materials • Perform other duties as assigned and comply with policies and standards

🎯 Requirements

• 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 • Must be authorized to work in the U.S. without the need for employment-based visa sponsorship now or in the future • 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

🏖️ Benefits

• Competitive pay • Health insurance • 401K and 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

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