Job Description
Position Purpose: Responsible for researching and analyzing Medicaid regulations and managing deliverables, as assigned. Serve as a liaison with the state Medicaid regulator. Perform trend analysis and assessment activities of high-level operational controls.
Key Details: This fully remote role requires availability during Pacific Time business hours. Candidates should have 5+ years of compliance and regulatory experience and a bachelor's degree in Healthcare, a related field, or equivalent experience. Ideal candidates will have experience supporting Washington Apple Health Medicaid managed care programs, working directly with state regulators, and managing formal regulatory communications. Strong technical writing skills and the ability to interpret complex regulatory and contractual requirements and translate them into clear operational guidance are essential. This role will regularly participate in external meetings with state agencies and stakeholders, including documenting key discussions, action items, and follow-up activities.
In this role, you will: - As a liaison with the state Medicaid regulator, coordinate a high volume of incoming and outgoing regulatory communications, oversee complex audit deliverables and coordinate timely review and submission of regulatory deliverables
- Research health care and related regulations using various electronic resources, including the Washington Administrative Code, Federal Register and Code of Federal Regulations
- Identify laws and regulations that affect health plan operations, including those related to Medicare, Medicaid, and the Patient Protection and Affordable Care Act (ACA), and those issued by relevant agencies, including CMS and Medicaid agencies of the various states
- Review and analyze legislative bills for impact to health plan
- Draft and issue summaries of regulatory updates to internal customers of regulations and compliance related regulations that affect health plan operations
- Respond to inquiries from internal stakeholders relating to non-routine questions relating to regulatory or related matter
- Coordinate cross-functional meetings to provide regulatory updates and track operational implementation of regulatory requirements
- Collaborate with internal and external teams, legal and regulatory resources regarding solutions to address potential legal, contractual and/or regulatory issues
- Conduct ad hoc research to analyze, interpret and disseminate guidance on contractual and regulatory requirements
- Draft regulatory operations policies, procedures and job aids
Education/Experience: Bachelor's degree in Healthcare, related field or equivalent experience. 5+ years of compliance and regulatory experience. Experience with licensure filings, corporate governance, and contract management is preferred, ideally within the Medicare or Medicaid industry.
Pay Range: $70,100.00 - $126,200.00 per year
At Centene, we connect people to the care they need to live healthier lives - and the work you do here makes that impact real every day. You'll take on meaningful challenges that directly support individuals, families, and communities, building your skills while making healthcare more accessible and effective. It's work with a purpose you can see, backed by a team committed to improving lives well beyond the workday.
Centene offers a comprehensive benefits package including: competitive pay, 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 work schedules. Actual pay will be adjusted based on an individual's 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.
Centene is an equal opportunity employer that is committed to diversity, and values the ways in which we are different. All qualified applicants will receive consideration for employment without regard to race, color, religion, sex, sexual orientation, gender identity, national origin, disability, veteran status, or other characteristic protected by applicable law.
Qualified applicants with arrest or conviction records will be considered in accordance with the LA County Ordinance and the California Fair Chance Act
Job Tags
Full time, Contract work, Part time, Work at office, Remote work, Flexible hours