Regulatory Operations Analyst III – Medicaid

🔥 13 minutes ago

🌲 Oregon – Remote

🌲 Oregon – Remote

💵 $70.1k - $126.2k / year

⏰ Full Time

🟡 Mid-level

🟠 Senior

⚙️ Operations

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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 • 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

🎯 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 • 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

🏖️ Benefits

• 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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