Manager, Regulatory Affairs (Member Policy/EOC’s)

03 Nov, 2021


Manager, Regulatory Affairs (Member Policy/EOC’s)

Centene Corp.
Remote/Chicago, IL/Woodland Hills, CA/Tigard, OR/Clayton, MO/Tampa, FL

You could be the one who changes everything for our 25 million members. Centene is transforming the health of our communities, one person at a time. As a diversified, multi-national organization, you’ll have access to competitive benefits including a fresh perspective on workplace flexibility.

<color:#107ba4;>Position Purpose:</color:#107ba4;>

Develop and execute regulatory plans for complex projects including maintenance of member coverage policies for existing and new business opportunities. Manage member contractual documents and track performance to contractual requirements, provide consultation to other departments on requirements and escalate gaps as necessary. Manages the development process (including quality reviews) for the creation of member policy documents, including Evidence of Coverage, for all Centene commercial products.

  • Review complex laws and regulations and provide guidance to other departments to ensure processes are in compliance, incorporates updates into member policy documentation
  • Perform gap analysis to current contract requirements and policies/procedures and offer recommendations to close gaps
  • Communicate with regulators as needed to seek clarification on licensing requirements, regulations, processes or documents submitted for approval
  • Maintain contract database to ensure all contracts are loaded and up to date in the system
  • Escalates and manages issues through resolution
  • Performs administrative duties such as performance evaluation, hiring, firing, salary recommendation and similar for staff

Bachelor’s degree in a related field or equivalent experience.
4+ years of public health policy, regulatory or legal experience, preferably in managed care or pharmacy industry.
Solid communication skills (written and verbal) including the ability to concisely explain complicated concepts to executives preferred.
Experience analyzing legislation and/or regulations and conveying findings preferred.
Understanding of the policy issues impacting the healthcare sector, business dynamics in the healthcare marketplace, and how federal and state policy impacts the industry preferred
Microsoft Office skills, including PowerPoint and Word preferred.
Experience working within a business that’s highly regulated preferred

Our Comprehensive Benefits Package:

  • Flexible work solutions including remote options, hybrid work schedules and dress flexibility
  • Competitive pay
  • Paid Time Off including paid holidays
  • Health insurance coverage for you and dependents
  • 401(k) and stock purchase plans
  • Tuition reimbursement and best-in-class training and development

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.

Learn more here

Job posted: 2021-11-03