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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
At Centene, we connect people to the care they need to live healthier lives — and the work you do here makes that impact real every day. You’ll take on meaningful challenges that directly support individuals, families, and communities, building your skills while making healthcare more accessible and effective. It’s work with a purpose you can see, backed by a team committed to improving lives well beyond the workday.
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, including full-time or part-time status. Total compensation may also include additional forms of incentives. Benefits may be subject to program eligibility.
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