Manager, Regulatory & Filing Operations

Centene Management Company LLC; Missouri; Hybrid; USD 88,000 - 158,000; Full time

Benefits offered by this job

Competitive pay

Health insurance

401K and stock purchase plans

Tuition reimbursement

Paid time off plus holidays

Flexible work arrangements

Job summary

Centene Management Company LLC is seeking a Regulatory Affairs professional to oversee filing submissions, interpret state laws, and develop member materials and QHP templates. You will serve as the primary point of contact for health plan and DOI communications, coordinating cross-functional teams and driving quality across outputs.

This fully remote role within the United States requires a bachelor’s degree and 5+ years of regulatory experience with CMS and state regulations.

Qualifications

• Bachelor’s degree required; 5+ years of regulatory experience preferred.
• Experience in policy analysis and product filing or QHP documentation (CMS or State DOI).

Responsibilities

• Lead regulatory research, policy analysis, and risk assessments for filings and amendments.
• Coordinate cross-functional projects and liaise with IT for product benefit database enhancements.
• Provide QA on regulatory outputs and maintain Source of Truth documentation.

Education

Bachelor’s degree in Business, Communications, Healthcare, Political Science

Job description

Position Purpose:

Manage assigned functional area (filing submissions; state legislative/regulatory interpretation and policy research; development of member materials or QHP templates, and/or product benefit database). Responsible for quality of their functional area outputs. Regulatory oversight and advocacy positioning, as it relates to functional area. Understand how cross-functional teams and business units work, including regulatory and/or benefit impacts to their functional areas. Serve as the Primary Point of Contact for Health Plan and State Department of Insurance (DOI) communications.

Key Details:

The role is fully remote within the United States. 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 for this opportunity, including employment-based visa types H-1B, L-1, O-1, H-1B1, F-1, J-1, OPT, or CPT. Manage the team’s review, interpretation, and summarization of current, proposed, and enacted legislation and/or regulatory updates, including risk assessments and/or risk feedback communications to business leads and leadership. Manage, coordinate, develop, monitor, and lead projects (regulatory or filing) internal to the department and cross-functional business partners, including product filings and submissions (CMS and State DOIs). Manage and perform quality assurance audits on department work product, including regulatory research, filings, member-facing policy documents, projects, and communications. Manage the maintenance of the product benefit system utilized as the Source of Truth for all Qualified Health Plan (QHP) template and member document population. Supervise and/or perform audit outputs from the Source of Truth system and/or document. Achieve a solid understanding of the team’s performance and use that assessment as a catalyst for performance, quality improvement and growth development for staff. Support the implementation of measurable, repeatable, scalable, and predictable processes related to organizational goals and drive continuous improvement to enable the department to scale efficiently and effectively. Responsible for working with IT on system enhancements and/or fixes to the product benefit database. Manages staff working with IT on product benefit database. Performs other duties as assigned. Complies with all policies and standards.

Education/Experience:

Bachelor’s degree, preferably in Business, Communications, Healthcare, Political Science, or 5+ years of regulatory experience, including policy analysis and/ or product filing or Qualified Health Plan (QHP documentation and template creation (CMS and/ or State DOI). Experience in commercial health insurance or a highly regulated industry. Pre-Law, Master’s Degree or JD desirable. 0-3 years of supervisory/management experience. In depth knowledge of health products, procedures, and state insurance regulations. Experience providing product regulatory proposals and recommendations.

Travel:

20% within continental United States.

Pay Range:

$87,700.00 - $157,800.00 per year

Benefits:

• competitive pay
• health insurance
• 401K and stock purchase plans
• tuition reimbursement
• paid time off plus holidays
• a flexible approach to work with remote, hybrid, field or office work schedules

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. Qualified applicants with arrest or conviction records will be considered in accordance with the LA County Ordinance and the California Fair Chance Act

Centene is committed to helping people live healthier lives. We provide access to high-quality healthcare, innovative programs and a wide range of health solutions that help families and individuals get well, stay well and be well.