Regulatory Operations Analyst III

Centene Corporation•Remote-MO, MI

3d•$70,100 - $126,200

About The Position

The Regulatory Operations Analyst III reviews, interprets, and summarizes proposed and enacted legislation and regulatory updates, serving as a subject matter expert on complex topics. The role conducts state and federal policy research and regulatory change monitoring to support formal regulatory approval of Commercial/Marketplace products. Working hours are Central Standard Time (CST). Applicants must be authorized to work in the United States without current or future employment-based visa sponsorship. The analyst researches regulatory requirements across multiple states and at the federal level, assesses business impacts and risks, advises internal teams on emerging regulations, and helps resolve legal, contractual, and regulatory issues. The role works with health plans, regulatory agencies, Legal, Compliance, and other internal departments; drafts responses and regulatory filing materials; and supports new state entry and product development. The analyst also contributes to junior employee development and training materials.

Requirements

Bachelor's degree in Business, Communications, Healthcare, Political Science/Pre-Law, or equivalent experience.
At least 4 years of experience in health insurance, legal, compliance, or a related field.
Must be authorized to work in the United States without the need for current or future employment-based visa sponsorship.

Nice To Haves

Master's degree in a related field or Juris Doctorate may be considered in place of experience.
Experience reviewing regulations and providing interpretation using language appropriate to the audience.
Experience in commercial health insurance and/or behavioral health managed care.

Responsibilities

Identify, analyze, and interpret proposed or enacted federal and state legislation related to assigned products, and communicate findings to impacted departments.
Independently conduct risk assessments, including impacts to business applications and downstream outputs.
Maintain databases and reference materials concerning legislative and regulatory issues and compliance.
Analyze, review, summarize, and disseminate complex regulatory updates concerning Commercial/ACA rules and regulations at the state or federal level.
Lead regulatory interpretation for Commercial/ACA rules and commercial products, adapting explanations and presentations to the audience; advise the business as regulations emerge.
Use persuasive arguments and secure business cooperation to address potential legal, contractual, and regulatory issues; determine appropriate approaches to regulatory problems.
Build relationships across varied audiences and collaborate with functional areas to lead projects and initiatives.
Represent the department in cross-functional meetings, provide guidance on regulatory requirements, and escalate matters to management as appropriate.
Work with internal departments, Legal, and Compliance to address potential legal, contractual, and regulatory issues.
Support and manage relationships between health plans and state and federal regulatory agencies.
Independently draft responses to external information requests for regulatory filings or policy needs.
Understand regulations and business needs across multiple states, as well as federal regulations affecting the commercial health insurance market.
Assess objections concerning regulatory interpretation and lead drafting of appropriate responses to regulators regarding Commercial/ACA filings, partnering with cross-functional teams as needed.
Lead and support regulatory guardrails for new state entry and product development, working with Legal on Certificate of Authority (COA) application materials and submissions.
Assist with developing and mentoring junior employees and creating or revising training materials.
Perform other duties as assigned and comply with all policies and standards.