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: Responsible for the timely, consistent, and accurate communication of state and federal regulatory updates related to the regulatory filing of commercial plans. Prepares, organizes, and submits the annual QHP and Off-Exchange product filings for assigned states using Health Insurance Oversight System (HIOS) and System for Electronic Rates & Forms Filing (SERFF).
- Monitors regulatory guidance and requirements affecting Centene’s commercial products. Analyzes, interprets, summarizes and distributes regulatory filing guidance to impacted cross-functional departments. Provides guidance to business to help them understand regulatory filing requirements and timelines.
- Executes timely and accurate formal regulatory filings, including the annual QHP and off-exchange product filings, seeking approval of our commercial health products within Health Insurance Oversight System (HIOS) and System for Electronic Rates & Forms Filing (SERFF) for assigned states ensuring deliverables spanning across multiple departments are received and appropriately filed.
- Acts as the primary contact between Regulators and the company, supporting communication during the filing season as needed. Manages relationship with regulatory agencies (Department of Insurance and Centers for Medicare & Medicaid Services (CMS)) related to the commercial filings. Leads responses to DOI objections and CMS correction communications for assigned states. Partners closely with health plans in managing relationships with regulatory agencies, including state regulators and State Based Exchanges.
- Conducts assigned special projects and maintains multiple critical trackers related to filing work. Should have the ability to understand the needs of internal and cross-functional departments and communicate those needs effectively at the appropriate level of detail for the audience.
- Performs regulatory filing research to aid in the development of new products and initiatives for the Enterprise related to commercial products. Responsibility for understanding regulations and business needs for multiple states, as well as federal regulations pertaining to the commercial health insurance market.
- Interprets and distributes data collected throughout the filing season to aid in proactively updating processes for ongoing improvement across multiple departments.
- Creates and maintains a deliverables chart which outlines all required documents needed for state specific filings. Audits trackers and deliverable for assigned states to ensure consistency and quality across teams.
- Develop trust-based relationships and collaborates with other functional areas to collect information, follow up with team and others for project deliverables and serves as a Subject Matter Expert. Leads sub-projects and smaller initiatives.
- Maintains and implements department policies, procedures, and work processes.
- Identifies, analyzes, and manages resolution of filing related issues for low risk states. May attend external and/or virtual conferences and seminars to evaluate industry trends.
- Performs other duties as assigned.
- Complies with all policies and standards.
Education/Experience:
- Bachelor's Degree Business, Communications, Healthcare, Political Science/ Pre-Law or equivalent experience required.
- 3+ years Regulatory experience, including product regulatory filings (CMS and/ or State DOI).
- Experience in commercial health insurance required.
Pay Range: $25.97 - $46.68 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
