Regulatory Operations Business Analyst III

🔥 4 minutes ago

🏰 Missouri – Remote

🏰 Missouri – Remote

💵 $70.1k - $126.2k / year

⏰ Full Time

🟡 Mid-level

🟠 Senior

⚙️ Business Operations

👻 Ghost score 0%

What it means: how likely this posting is sitting open without active hiring.How to read it: 60% or higher means we think this is a ghost. Lower scores are less of a worry.How we score it: age, reposts, open roles vs team size, how fast jobs close, and whether pay is listed.Fine print: an estimate from public data, not a judgment of the company. Real jobs can score high, so treat it as a hint, not a fact.

Apply Now

Find Similar Remote Jobs

Set Up Email Alert For New Jobs

📊 Check your resume score for this job

Improve your chances of getting an interview by checking your resume score before you apply.

Upload Resume

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

• Perform or assist with regulatory filings for medium/high risk states seeking annual approval for individual commercial marketplace products • Complete Qualified Health Plans (QHP) federal and/or state application templates and documents • Guide and conduct special projects • Review and interpret application instructions from regulatory agencies such as DOI and CMS • Assist in developing and implementing auditing and monitoring strategies • Perform root cause analysis for continuous improvement and special project development • Prepare QHP templates and formal regulatory filing documents for HIOS and SERFF filings • Audit QHP documents for compliance, accuracy, and alignment with product intent • Manage and collaborate with Sources of Truth document owners on QHP filing templates and policy forms • Participate in cross-functional meetings and lead meetings as needed • Analyze legislation and regulatory orders and communicate impacts and risks • Lead implementation of legislation and regulations affecting QHP work • Coordinate maintenance, implementation, and continuous improvement of department policies, procedures, and work processes • Assist with regulatory agency relationships involving DOI and CMS • Lead onboarding and training of analysts and maintain training materials • Coordinate and lead internal departmental projects as a subject matter expert • Attend external and/or virtual conferences and seminars to evaluate industry trends • Perform other duties as assigned and comply with policies and standards

🎯 Requirements

• Bachelor's Degree Business, Communications, Health Care, Political Science or equivalent experience required • 4+ years business process or data analysis experience in health insurance, legal, compliance or related area required • Experience in commercial health insurance and/or behavioral health managed care preferred • Experience drafting and auditing filing documentation (Summary of Benefit Coverage, Schedule of Benefits, etc.) or QHP Templates (Plans and Benefit, Pharmacy, Crosswalk, etc.) preferred • Experience auditing database or QHP filing documentation preferred • Knowledge of SERFF and/or HIOS systems preferred • Must be authorized to work in the U.S. without the need for employment-based visa sponsorship now or in the future • Sponsorship and future sponsorship are not available, including employment-based visa types H-1B, L-1, O-1, H-1B1, F-1, J-1, OPT, or CPT

🏖️ 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