Senior Contracts Analyst - HIOS

Blue Cross Blue Shield of Massachusetts•Boston, MA

4d•$80,370 - $98,230•Hybrid

About The Position

The position of HIOS Contracts Analyst in the Contracts Development & Contracts Delivery team is an individual contributor that is accountable for the development and administration of the company’s health plan policies and account contracts in compliance with operational requirements and applicable health insurance laws and regulations. The HIOS Contracts Analyst will have a focused responsibility on completing the required submissions of corporate, product, and plan data annually through the Health Insurance Oversight System (HIOS) and the Rates and Benefits Information System (RBIS). The HIOS Contracts Analyst will also be responsible for coordinating all activities related to the mandated annual corporate DOI filings for the Merged Market, Qualified Health Plans (QHPs), and Qualified Dental Plans (QDPs). This position requires working with a cross-functional team of associates responsible for creating documents required for these filings. The HIOS Contracts Analyst will: Ensure accurate and up-to-date plan design listings and corresponding plan identification information (such as plan status, HIOS numbers, AV tier, etc.) through the development and maintenance of the annual Standard Products Listing, annual Standard Products Tracking, annual OLB EOC Policy Form Table Updates, and Custom Products Tracking. Actively participate in the implementation of state and federal mandates (such as the Consolidated Appropriations Act under federal law), new products, product changes, and corporate initiatives by attending workgroup meetings, analyzing changes, documenting impacts, drafting new language, making updates to Product Master and BARS and representing the department on cross‑functional workgroups and/or working with team Managers on department sub-projects. Develop and implement new and revised policy forms and contracts for all product lines and financial arrangements as required to support state and federal legislation requirements, regulatory requirements and new plan offerings. Review and respond to nonstandard benefit requests to support sales and service processes/workflows; Actively support sales and service processes and workflows by analyzing benefit requests of all complexity levels and providing thorough, accurate, and timely responses. This position is eligible for the Flex persona. Your Day to Day: Manage the federal Health Information Oversight System (HIOS) filing process on behalf of BCBSMA. Attention to detail is needed throughout the filing process to obtain, maintain and process required corporate information, including product, enrollment and other requested data to ensure corporate regulatory compliance with quarterly and annual deadlines. Assess requirements for annual DOI filings for the Merged Market, Qualified Health Plans (QHPs), and Qualified Dental Plans (QDPs); Identify changes in the filing requirements, key deliverable dates, and impacted business areas. Assemble implementation team participants and facilitate implementation meetings; document identified issues and ensure resolution; and develop the corporate filing approach to submit to required regulatory agencies accurately and on time.

Requirements

1-3+ years of experience in contract administration, including product development and implementation.
Collaborative, problem solving approach with an openness to change.
Excellent written and oral communication skills; excellent analytical, research, and problem-solving skills.
Ability to meet aggressive timelines; ability to understand corporate priorities, work to those goals and re-prioritize on a daily basis.
Ability to analyze benefit structures from a variety of perspectives, including regulatory compliance, contracts structure and operational requirements, and business need and business risk.

Nice To Haves

Supervisory experience, or experience leading cross functional projects preferred.

Responsibilities

Ensure accurate and up-to-date plan design listings and corresponding plan identification information (such as plan status, HIOS numbers, AV tier, etc.) through the development and maintenance of the annual Standard Products Listing, annual Standard Products Tracking, annual OLB EOC Policy Form Table Updates, and Custom Products Tracking.
Actively participate in the implementation of state and federal mandates (such as the Consolidated Appropriations Act under federal law), new products, product changes, and corporate initiatives by attending workgroup meetings, analyzing changes, documenting impacts, drafting new language, making updates to Product Master and BARS and representing the department on cross‑functional workgroups and/or working with team Managers on department sub-projects.
Develop and implement new and revised policy forms and contracts for all product lines and financial arrangements as required to support state and federal legislation requirements, regulatory requirements and new plan offerings.
Review and respond to nonstandard benefit requests to support sales and service processes/workflows; Actively support sales and service processes and workflows by analyzing benefit requests of all complexity levels and providing thorough, accurate, and timely responses.
Manage the federal Health Information Oversight System (HIOS) filing process on behalf of BCBSMA. Attention to detail is needed throughout the filing process to obtain, maintain and process required corporate information, including product, enrollment and other requested data to ensure corporate regulatory compliance with quarterly and annual deadlines.
Assess requirements for annual DOI filings for the Merged Market, Qualified Health Plans (QHPs), and Qualified Dental Plans (QDPs); Identify changes in the filing requirements, key deliverable dates, and impacted business areas.
Assemble implementation team participants and facilitate implementation meetings; document identified issues and ensure resolution; and develop the corporate filing approach to submit to required regulatory agencies accurately and on time.