What are the responsibilities and job description for the Regulatory Operations Analyst II - IDR Operations position at Centene Commercial Solutions?
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.
Applicants for this job have the flexibility to work remote from home anywhere in the Continental United States.
Position Purpose : Reviews, interprets and summarizes proposed and enacted legislation and regulatory updates, and subsequently communicates impact to the business. Performs regulatory / legislative research and issue advocacy for assigned states.
- Identifies, analyzes and interprets proposed or enacted legislation and communicates findings to impacted departments. Resolves policy issues which may negatively impact service to members seeking input and feedback from cross-functional areas. Responsible for summarizing the feedback and providing guidance to the business on impacts of rules / regulations.
- Responsibility for understanding regulations and business needs for multiple states, as well as federal regulations pertaining to the commercial health insurance market.
- Conduct research projects to analyze, interpret and disseminate guidance on legal, contractual and regulatory requirements for assigned states or subject matter expert areas.
- Identifies, analyzes, interprets, and communicates state and federal commercial / ACA requirements to internal stakeholders, collaborating with cross-functional partners on implementation of federal commercial / ACA requirements. Guides the business in making decisions related to state and federal commercial / ACA requirements.
- Identify, analyze, and resolve regulatory or legislative issues.
- Demonstrate effective verbal and written communication skills to collaborate with key stakeholders across levels of the organization.
- Leads sub-projects and smaller initiatives related to regulatory interpretation and implementation of regulatory requirements, responsible for providing direction to business related to initiatives.
- Solutions to address potential legal, contractual and / or regulatory issues which arise working closely with Legal and Compliance.
- Work with health plans in managing relationships with regulatory agencies, including state and federal regulators. Drafts and submits responses to internal and external requests and inquiries for information, including from regulatory bodies.
- Partner in the maintenance and implementation of department policies, procedures, and work processes.
- Performs data entry into Source of Truth used in departmental tracking of regulatory / legislative activity. Maintains critical internal filing trackers and other reference materials related to work performed.
- May attend external and / or virtual conferences and seminars to evaluate industry trends. Performs other duties as assigned.
- Performs other duties as assigned.
- Complies with all policies and standards.
Education / Experience :
Pay Range : $26.50 - $47.59 per hour
Centene offers a comprehensive benefits package including : competitive pay, health insurance, 401K and stock purchase plans, tuition reimbursement, paid time off plus holidays, and a flexible approach to work with remote, hybrid, field or office work schedules. Actual pay will be adjusted based on an individual's skills, experience, education, and other job-related factors permitted by law. Total compensation may also include additional forms of incentives.
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
Salary : $27 - $48
