Regulatory Operations Analyst II (Remote)

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.

Position Purpose: Performs or assists with formal regulatory filings seeking approval of commercial products for the commercial markets, and/or performs policy research and issue advocacy. Conducts assigned special projects, provides regulatory interpretation, and performs reporting. Responsible for creation of QHP templates and/or member policy documents, including Evidence of Coverage and schedules, for commercial products for medium-risk states.

Monitors pending legislation and regulations affecting Centene’s commercial product in medium risk states. Analyzes and interprets the proposed or enacted legislation and communicates to impacted departments. Assists partners with implementation of passed legislation or new regulations.
Assists with managing relationship with regulatory agencies (Department of Insurance and Centers for Medicare & Medicaid Services (CMS)).
Maintains and reviews regulatory documentation necessary to maintain corporate standards. Assists in the maintenance and implementation of department policies, procedures, and work processes.
Oversees and prepares formal regulatory filings, seeking approval of our commercial health plans within Health Insurance Oversight System (HIOS) and System for Electronic Rates & Forms Filing (SERFF) for medium-risk states.
Creates and audits member policy documentation, including Evidence of Coverage and Schedules of Benefits, for medium-risk states.
Creates and audits Qualified Health Plan (QHP) templates for medium-risk states.
Performs data entry into Source of Truth used for QHP template and member document population, and audits data inputs.

Education/Experience: Associate’s degree or equivalent experience required. Bachelor’s degree in Business, Communications, Healthcare, Political Science/ Pre-Law preferred. 2+ years of experience in health insurance, legal, or compliance required. Experience in commercial health insurance and/or behavioral health managed care preferred. Knowledge of SERFF and HIOS preferred.

Our Comprehensive Benefits Package: Flexible work solutions including remote options, hybrid work schedules and dress flexibility, Competitive pay, Paid time off including holidays, Health insurance coverage for you and your dependents, 401(k) and stock purchase plans, Tuition reimbursement and best-in-class training and development.

Centene is an equal opportunity employer that is committed to diversity, and values the ways in which we are different. All qualified applicants will receive consideration for employment without regard to race, color, religion, sex, sexual orientation, gender identity, national origin, disability, veteran status, or other characteristic protected by applicable law.