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: Supervises formal regulatory filing submission processes, seeking regulatory approval of commercial products for the commercial markets and/or supervises policy research, regulatory interpretation, and issue advocacy. Supervises the development process (including quality review) for the creation of Qualified Health Plan (QHP) templates and/or member policy documents, including Evidence of Coverage (EOC) and benefit schedules, for commercial products. Responsible for working with IT on system enhancements and/or fixes to the product benefit database. Lead special projects and large initiatives; develops and supervises auditing and quality initiative strategies.
Supervises the review, interpretation, and summarization of proposed and enacted legislation and/or regulatory updates, including risk assessments and/or risk feedback communications to business leads and leadership.Supervises, 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).Supervises and performs quality assurance audits on department work product, including regulatory research, filings, member policy documents, projects, communications (written and/or verbal).Supervises and maintains the product benefit system utilized as the Source of Truth for all QHP, template and member document population and perform audit outputs from the Source of Truth system and/or document.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.Education/Experience:
4+ years of experience in commercial health insurance or a highly regulated industry and/or a Bachelor’s degree in Business, Communications, Healthcare, Political Science or Pre-Law or related degree. Masters or JD is preferred.In depth knowledge of health products, procedures, and state insurance regulations.Knowledge of SERFF and HIOS or prior experience with state filing documents in healthcare preferred.Solid communication skills (written and verbal), including the ability to concisely explain complicated concepts to leadership.Experience analyzing legislation and/or regulations and conveying findings.Experience providing product regulatory proposals and recommendations.
Travel: 20% All within the Continental US.
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