Regulatory Operations Analyst IV: QHP Filing Leader (Remote)

Centene Corporation; United States; Hybrid; USD 88,000 - 158,000; Full time

Benefits offered by this job

Health insurance

401K and stock purchase plans

Tuition reimbursement

Paid time off and holidays

Job summary

Centene Corporation seeks a Regulatory Operations professional to prepare Qualified Health Plan templates and regulatory filing documents for HIOS and SERFF submissions, ensuring compliance and quality control across high-risk states. The role includes mentoring junior staff and leading audits with cross-functional teams.

The position involves analyzing proposed regulations, coordinating training, and driving continuous improvement in filing processes, while supporting the department's strategic

Qualifications

• Bachelor's degree in business/healthcare or related field required; Master's preferred.
• 6+ years in business process or data analysis in health insurance, legal, compliance.
• Experience with commercial health insurance and/or behavioral health managed care preferred.
• Experience drafting/auditing filing documentation (SB&C, Schedule of Benefits, etc.), QHP Templates (Plans and Benefit, Pharmacy, Crosswalk, etc.) or related area preferred.
• Knowledge of SERFF and HIOS systems preferred.
• Experience auditing QHP documents preferred.

Responsibilities

• Prepare and oversee completion of QHP templates and regulatory filing documents for HIOS/SERFF filings for high-risk states.
• Audit QHP documents for quality control and compliance with regulations and internal standards.
• Lead cross-functional meetings and representation of Regulatory Operations in multi-team forums.
• Mentor junior staff and oversee completion of work.
• Coordinate, develop, monitor and lead projects within the department and with partners.

Skills

Regulatory knowledge

Data analysis

Project management

Mentoring

Cross-functional collaboration

Education

Bachelor's degree

Master's degree preferred

Tools

SERFF

HIOS

Job description

Centene Corporation seeks a Regulatory Operations professional to prepare Qualified Health Plan templates and regulatory filing documents for HIOS and SERFF submissions, ensuring compliance and quality control across high-risk states. The role includes mentoring junior staff and leading audits with cross-functional teams.

The position involves analyzing proposed regulations, coordinating training, and driving continuous improvement in filing processes, while supporting the department's strategic