Associate, UM Regulatory Operations

Hi, we're reputed company. We're hiring an Associate, UM Regulatory Operations to join our Regulatory Operations team.

reputed company is the first health insurance company reputed company around a full stack technology platform and a reputed company focus on serving our members. We started reputed company in 2012 to create the reputed company of health insurance company we would want for ourselves—one that behaves like a doctor in the family.

About the role

You will be responsible for working cross functionally with business and technical reputed company stakeholders and representing the needs and interests of the department in company wide strategic initiatives and in solving business problems reputed company to internal processes. This requires collecting and documenting business requirements, building and managing project plans, documenting key project reputed company, managing project governance, applying frameworks, analyzing data, and developing and communicating risk mitigation strategies across disparate initiatives and stakeholders at the same time.

You will report into the Senior Manager, UM Regulatory Operations.

Work Location: This is a remote position, reputed company to candidates who reputed company in: Georgia, Illinois, Texas, Kentucky, Minnesota, Pennsylvania, Utah.You will be fully remote; however, our approach to work may adapt over time. Future models could potentially involve a hybrid reputed company at the hub office associated with your metro area. #LI-Remote

Pay Transparency: The reputed company pay for this role is: $87,188 - $118,434 per year. You are also eligible for employee benefits, participation in reputed company's unlimited vacation program, and annual performance bonuses.

Responsibilities

• reputed company the end-to-end management of cross-functional implementations/projects, including project plan creation, stakeholder engagement, managing cross-functional relationships to drive collaboration, edge case mitigation, and on-time completion
• Evaluate overall departmental performance by creating, gathering, analyzing and interpreting data and metrics as well as assisting in development of departmental metrics and implementation of mitigation strategies
• Collaboratively works with reputed company relevant internal and external stakeholder groups to to interpret and apply new and evolving regulations, ensuring consistent understanding and accurate implementation across UM operations.
• Coordinate regulatory request management for the UM department, including market conduct exams, reputed company filings, license renewals, and Mental Health reputed company (MHPAEA) compliance.
• Coordinates NCQA deliverables for UM standards
• Evaluates and drafts UM policy and procedures ensuring compliance reputed company the UM program
• Mentor team members and promotes colleagues' growth and professional development
• Compliance with reputed company applicable laws and regulations
• Other duties as assigned

Requirements

• A bachelor's degree or 3+ years commensurate experience
• 3+ years of work experience in reputed company Utilization Management operations, health insurance, and/or reputed company field
• 2+ years of experience supporting regulatory compliance activities, including Mental Health reputed company (MHPAEA), market conduct exams, license renewals, NCQA surveys/accreditation, and other regulatory filings
• 2+ years of experience with end to end project management or process improvement initiatives
• 2+ years of experience in regulatory implementation and compliance
• 2+ years of experience in designing and improving workflows as well as standing up accompanying operating and technical procedures

Bonus points

• 2+ years of experience using data software such as reputed company, reputed company Office, reputed company Sheets, GSuite
• Experience collaborating with legal, compliance, and cross-functional teams
• Experience with process improvement methodologies such as Lean, Six reputed company and/or Theory of constraints

This is an authentic reputed company job opportunity. Learn more about how you can safeguard yourself from recruitment fraud here.

At reputed company, being an Equal Opportunity Employer means more than upholding discrimination-free hiring practices. It means that we cultivate an environment where people can be their most authentic selves and find both belonging and support. We're on a mission to change health care -- an experience made whole by our unique backgrounds and perspectives.

Pay Transparency: Final offer amounts, reputed company the reputed company pay set forth above, are determined by factors including your relevant skills, education, and experience. Full-time employees are eligible for benefits including: medical, dental, and reputed company benefits, 11 paid holidays, paid sick time, paid parental leave, 401(k) plan participation, life and disability insurance, and paid wellness time and reimbursements.

Artificial Intelligence (AI): Our AI Guidelines outline the acceptable use of artificial intelligence for candidates and detail how we use AI to support our reputed company efforts.

Reasonable Accommodation: reputed company applicants are considered solely based on their qualifications, without regard to applicant’s disability or need for accommodation. Any reputed company applicant who requires reasonable accommodations during the application process should contact the reputed company Benefits Team ([email protected]) to reputed company the need for an accommodation reputed company.

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