Manager, Regulatory & Filing Operations

Overview

This fully remote role within the United States manages an assigned functional area, including:

• Filing submissions
• State legislative/regulatory interpretation and policy research
• Development of member materials and/or QHP templates
• Maintenance of a product benefit database

The position is responsible for the quality of functional area outputs, regulatory oversight and advocacy positioning, and serves as the primary point of contact for Health Plan and State Department of Insurance (DOI) communications.

Responsibilities

• 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 regulatory or filing projects 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 used as the Source of Truth for Qualified Health Plan (QHP) template and member document population.
• Supervise and/or perform audit outputs from the Source of Truth system and/or document.
• Assess team performance and use findings to drive performance, quality improvement, and staff growth.
• Support implementation of measurable, repeatable, scalable, and predictable processes aligned to organizational goals, driving continuous improvement.
• Work with IT on system enhancements and/or fixes to the product benefit database.
• Manage staff working with IT on the product benefit database.
• Comply with all policies and standards.
• Perform other duties as assigned.

Requirements

• 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.
• In-depth knowledge of health products, procedures, and state insurance regulations, including experience providing product regulatory proposals and recommendations.
• 0–3 years of supervisory/management experience.
• Travel: 20% within continental 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.

Preferred Qualifications

• Pre-Law, Master’s Degree, or JD.

Compensation & Benefits

• Pay Range: $87,700.00 - $157,800.00 per year

Benefits may include:

• Health insurance
• 401K and stock purchase plans
• Tuition reimbursement
• Paid time off plus holidays
• Flexible approach to remote, hybrid, field, or office work schedules

Actual pay will be adjusted based on 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.

Location

• Fully remote within the United States.
• Travel: 20% within continental United States.