Commercial Markets Policy Specialist

The current hiring base salary range for this role is:

$82,297.00/year – 92,583.90/year

UCare anticipates paying within the above-references salary range for this position. The actual base salary offer for this position will be determined by a variety of components including but not limited to work experience, education, certifications, location of the role, internal equity, and other relevant factors.

LOCATION: Minneapolis, MN (Remote, Office for Your Day)

Position Description

As the Commercial Markets Policy Specialist, you will be responsible for consulting with internal and external stakeholders on day-to-day issues and questions related to regulatory interpretation and implementation for commercial health insurance markets. You will monitor, analyze, and disseminate federal and state regulatory requirements for commercial health insurance markets. You will serve as a liaison for internal stakeholders to federal and/or state regulators and agencies, including Centers for Medicare and Medicaid Services (CMS), Center for Consumer Information and Insurance Oversight (CCIIO), Minnesota Departments of Health (MDH) and Commerce, and MNsure. Consult with business areas to identify requirements and ensure compliant solutions that support the business’ goals; serve as the Subject Matter Expert (SME) on applicable commercial regulations; and respond to regulatory-related inquiries.

• Serve as a SME to staff on regulatory questions and/or issues. Consult with Commercial Team Manager on complex questions, subjects, and issues.

• Monitor, analyze, interpret, and distribute commercial market regulatory, legislative and policy information, including regulations and sub-regulatory guidance, to internal departments. Proactively identify impact to UCare’s commercial products. As assigned, coordinate projects or operational implementation to meet requirements.

• Serve as a liaison with regulators and agencies for commercial market requirements, including CMS, CCIIO, MDH, Dept. Commerce, and MNsure. Strive to ensure positive relationships are maintained, as well as timely and accurate responses to concerns and inquiries. Represent UCare at meetings and webinars with regulators, MNsure, and industry trade organization. Identify and coordinate business deliverables and impacts to work across the organization to meet expectations. Consult with regulators, MNsure staff, and internal employees regarding regulations, sub-regulatory guidance, and requirements, and how they impact commercial products.

• Collaborate with internal departments on the analysis and interpretation of regulatory, sub-regulatory and policy requirements to support departments in making effective management and compliance-related decisions. Assess existing and potential internal business policies and procedures and provide recommendations, clarity and applicability and compliance with new and emerging regulatory requirements. Support regulatory escalations from internal departments ensuring that all escalations are triaged, researched, and communicated accurately.

• Manage commercial reporting and filing activities to ensure compliance with federal and state requirements. Manage deliverables, timelines, and issue resolution to support timely, accurate and complete filings.

• Support analysis of regulatory issues due to contradictory guidance between federal and state regulatory entities. Collaborate with Corporate Compliance to address compliance issues.

• Serve as a SME and Super User for guidance distributed by the Commercial Team, using Compliance360. Use defined workflows and work collaboratively on issue resolution and process improvements.

• Other projects and duties as assigned.

Education

Bachelor’s degree; demonstrated experience may be considered in lieu of degree.

Required Experience

At least two years of experience working in a health plan, managed care, or health care delivery organization. Experience analyzing and communicating state and federal regulatory guidance for commercial markets, especially individual market requirements.

Preferred Experience

Working knowledge of health insurance environment and core business functions. Familiarity with regulatory submissions for commercial markets and Medicare Supplement rate filings, including SERFF and HIOS. Familiarity with federal regulatory requirements of commercial markets. Understanding of state regulations that apply to commercial markets. Experience with project management concepts and methodologies.

BENEFIT ELIGIBLITY

Candidates hired into this position will also be eligible to participate in the following benefit programs: Paid Time Off; Earned Safe and Sick Time; Paid Holidays; Parental Leave; 401K program; medical, dental, vision, life insurance; short-term and long-term disability insurance; Flexible Spending Account and/or Health Savings Account, subject to meeting the eligibility requirements and terms and conditions of these programs.

This job posting should not be construed as an offer of employment with certain terms, nor should it be construed as a guaranteed minimum. UCare's policies and benefits are subject to change in UCare's sole discretion, consistent with applicable law.