Regulatory Operations Business Analyst III

Position Purpose: Performs or assists with regulatory filings for medium/high risk states, seeking annual approval for individual commercial marketplace. Completes Qualified Health Plans (QHP) federal and/or state required application templates and documents for medium/high risk states, including policy forms for individual commercial marketplace products for low-risk states. Guides and conducts special projects; reviews and provides interpretation of application instructions from regulatory agencies such as Department of Insurance (DOI) and Centers for Medicare & Medicaid Services (CMS) and assists in the development of and implementation of auditing and monitoring strategies for medium/high-risk states. Performs root cause analysis to inform continuous improvement and special project development activities. Key Details : The role is fully remote within the continental United States. Must be authorized to work in the U.S. without the need for employment-based visa sponsorship now or in the future. Sponsorship and future sponsorship are not available for this opportunity, including employment-based visa types H-1B, L-1, O-1, H-1B1, F-1, J-1, OPT, or CPT. Oversees and prepares Qualified Health Plan templates and/or formal regulatory filing documents, seeking approval of our individual commercial marketplace health plans for Health Insurance Oversight System (HIOS) and System for Electronic Rates & Forms Filing (SERFF) filings for high-risk states. Audits QHP documents