Regulatory Operations Analyst III - Medicaid

Centene Corporation•Remote-OR, OR

4d•$70,100 - $126,200•Remote

About The Position

Centene is seeking a Regulatory Operations Analyst III - Medicaid to join their team. This role is responsible for reviewing, interpreting, and summarizing proposed and enacted legislation and regulatory updates as a subject matter expert. The position is remote for candidates located in Oregon only, with potential travel to the Salem office. Centene is a diversified, national organization focused on transforming the health of communities.

Requirements

Bachelor's degree in business, Communications, Healthcare, Political Science/Pre-Law or equivalent experience required.
4+ year's experience in health insurance, legal, compliance or related field required.
Experience reviewing regulations and providing interpretation using terms appropriate for the audience preferred.

Nice To Haves

Master's Degree in a related field, Juris Doctorate degree may be considered in place of experience.
Demonstrated ability to build and maintain effective working relationships with state regulators, particularly the Oregon Health Authority (OHA).
Strong technical understanding of Medicaid policy, administrative rules, and regulatory guidance; prior experience working at or with OHA is a plus.
High level of attention to detail and strong organizational skills to manage complex regulatory requirements and timelines.
Ability to translate highly technical regulatory and policy language into clear, plain-language guidance and actionable recommendations for internal collaborators.
Proven ability to thoughtfully and effectively advocate for regulatory clarifications or changes when appropriate.
Strong compliance mindset, with experience ensuring organizational practices align with regulatory and contractual requirements.
Experience in commercial health insurance and/or behavioral health managed care preferred.

Responsibilities

Tracking proposed changes to Oregon Administrative Rules (OAR), keeping SMEs updated, and collecting feedback.
Engaging in Rule Advisory Committees (RACs) and supporting the submission of written feedback to the Oregon Health Authority (OHA).
Acting as the business owner for the RLI (Regulatory Legislation Implementation) process.
Supporting the end-to-end process for the annual contract restatement, serving as the business owner.
Monitoring all changes from initial proposal through contract finalization and implementation.
Attending related meetings and collaborating with the project manager to track implementation status.
Identifying and escalating risks to the Executive Sponsor.
Analyzing contract amendments as they occur throughout the year.
Supporting Oregon Health Plan (OHP) contractor workgroups by attending meetings, sharing topics in advance, and distributing information afterward.
Responding to Requests for Information (RFIs) resulting from OHP contractor workgroup meetings.
Bringing SMEs together as needed to discuss pertinent topics.
Supporting monthly Division of Financial Regulation (DFR) meetings by attending, organizing follow-ups, and acting as the primary contact for rules, bulletins, and expectations.
Managing communications and ensuring compliance with regulatory requirements.
Performing other duties as assigned.
Complying with all policies and standards.