Regulatory Operations Analyst III

Overview

This role involves reviewing, interpreting, and summarizing proposed and enacted legislation and regulatory updates as a subject matter expert on complex policy topics. Responsibilities include state or federal policy research, regulatory change monitoring, and supporting efforts to achieve formal regulatory approval for Commercial/Marketplace products.

Working hours are CST (Central).

Responsibilities

• Identify, analyze, and interpret proposed or enacted legislation related to assigned products at the federal and state level; communicate findings to impacted departments.
• Independently perform risk assessments, including impacts to business applications and downstream output.
• Maintain databases and other reference materials related to legislative and regulatory issues and compliance.
• Conduct comprehensive, complex regulatory analyses, including reviewing, summarizing, and disseminating key regulatory updates and changes related to Commercial/ACA rules and regulations at the state and/or federal level.
• Lead regulatory interpretation related to Commercial/ACA rules and regulations for commercial products; explain concepts clearly and adapt language and presentation based on the audience level.
• Provide advice to business teams as new regulations emerge.
• Use persuasive arguments to secure business cooperation in addressing potential legal, contractual, and/or regulatory issues; determine appropriate approaches for solving regulatory problems.
• Build trust-based relationships with varied audiences and collaborate across functional areas to lead large projects and initiatives.
• Represent the department in cross-departmental meetings; provide guidance on regulatory requirements and appropriately escalate matters to management.
• Support solutions for legal, contractual, and/or regulatory issues by working closely with internal departments, Legal, and Compliance.
• Support and manage relationships between health plans and regulatory agencies, including state and federal regulators.
• Independently draft responses to external requests for information needed for regulatory filings and/or policy needs.
• Support regulatory understanding for multiple states, including federal regulations pertaining to the commercial health insurance market.
• Assess and analyze objections related to regulatory interpretation and lead drafting of responses provided to regulators for commercial/ACA filings; collaborate with cross-functional partners as needed.
• Lead and support regulatory guardrails for new state entry and new product development, including working with Legal on preparation of COA application materials/submissions for new states and/or products.
• Assist with developing and mentoring junior employees; support creation and revisions to training materials.
• Perform other duties as assigned.
• Comply with all policies and standards.

Requirements

• Bachelor’s Degree in Business, Communications, Healthcare, Political Science/Pre-Law or equivalent experience required.
• Master’s Degree in a related field and/or Juris Doctorate degree may be considered in place of experience preferred.
• 4+ years of experience in health insurance, legal, compliance, or related field required.
• Experience reviewing regulations and providing interpretation using terms appropriate for the audience preferred.
• Experience in commercial health insurance and/or behavioral health managed care preferred.

Authorization to Work

• 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, L-1, F-1, J-1, OPT, or CPT.

Compensation & Benefits

• Pay Range: $70,100.00 - $126,200.00 per year
• Comprehensive benefits package, including 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 schedules.
• Actual pay may 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

Working hours are CST (Central).