Regulatory Filing Analyst, Senior

Your Role

The Regulatory Filings team is responsible for supporting the Commercial, Medi-Cal and Medicare Advantage lines of business. The Regulatory Filing Analyst, Senior, will report to the Regulatory Filings Manager of the Health Law Group within the Law Department. In this role, you will ensure accurate, timely, and compliant submission of filings and reports to federal and state regulatory agencies, acting as a liaison between the organization and regulators, and will provide regulatory guidance to the business on state and federal requirements.

Our leadership model is about developing great leaders at all levels and creating opportunities for our people to grow - personally, professionally, and financially. We are looking for leaders that are energized by creative and critical thinking, building and sustaining high-performing teams, getting results the right way, and fostering continuous learning.

Your Knowledge and Experience

• Requires bachelor's degree or High School Diploma/GED and 4 years of additional relevant experience in lieu of a degree

• Requires 5 years of prior relevant experience (i.e. regulatory affairs or health insurance)

• Must have knowledge of the Knox Keene Act.

• Must be detail oriented, have effective written and verbal communication skills, organizational skills, and the capacity to manage competing priorities.

• Must have strong analytical and problem-solving skills.

• Must be Proficient in Microsoft Office (Word, Excel, and Outlook).

• Requires experience using data tracking tools or similar database management technology.

• Proficiency in the following regulatory filing systems is desired:

• Department of Managed Health Care (DMHC) Web Portal

• System for Electronic Rates & Forms Filing (SERFF)

• Health Insurance Oversight System (HIOS)

Hybrid

This role requires employees to be in-office based on our hybrid workplace model, balancing purposeful in-person collaboration with flexibility. For most teams, this means coming into the office two days each week.

Employees living more than 50 miles from an office location will work with their manager to determine in-office time based on business need.

• Prepare and submit various types of regulatory filings with the primary focus on the annual Qualified Health Plan (QHP) and off-exchange product and rate filings

• Serve as subject matter expert on assigned regulatory filing requirements, providing guidance to internal business partners on filing content, timing, and compliance considerations.

• Work collaboratively with internal business parters to write and edit the description of packaged filings for accurate representation of the company's proposals to the regulatory agencies for approval.

• Partner with the Government Programs team in submission of mirror filings to regulatory agencies.

• Actively participate as a Regulatory Filings stakeholder in projects and activities related company initiatives that impact various business units within the company (i.e. Legal, Mandates, Contracts, Network, Product Development Team, HCQA, Actuary, Global Business Services).

• Work independently under limited supervision with responsibility for meeting multiple filing deadlines set by internal business partners and the regulatory agencies.

• Collaborate with cross-functional teams to gather, evaluate, and validate materials and submit reports including filings required on a monthly, quarterly, or annual basis to regulatory agencies.

• Maintain filing trackers; monitor and communicate status of filings to internal business partners

• Maintain filing documentation and supporting records to ensure audit readiness and regulatory transparency.

• Provide research support to various internal business partners (i.e. Compliance, Internal Audits, Litigation & Subpoena, Appeals & Grievance) for internal and regulatory audits, enforcement matters and regulatory complaints, as requested.

• Prepare and submit various types of regulatory filings with the primary focus on the annual Qualified Health Plan (QHP) and off-exchange product and rate filings

• Serve as subject matter expert on assigned regulatory filing requirements, providing guidance to internal business partners on filing content, timing, and compliance considerations.

• Work collaboratively with internal business parters to write and edit the description of packaged filings for accurate representation of the company's proposals to the regulatory agencies for approval.

• Partner with the Government Programs team in submission of mirror filings to regulatory agencies.

• Actively participate as a Regulatory Filings stakeholder in projects and activities related company initiatives that impact various business units within the company (i.e. Legal, Mandates, Contracts, Network, Product Development Team, HCQA, Actuary, Global Business Services).

• Work independently under limited supervision with responsibility for meeting multiple filing deadlines set by internal business partners and the regulatory agencies.

• Collaborate with cross-functional teams to gather, evaluate, and validate materials and submit reports including filings required on a monthly, quarterly, or annual basis to regulatory agencies.

• Maintain filing trackers; monitor and communicate status of filings to internal business partners

• Maintain filing documentation and supporting records to ensure audit readiness and regulatory transparency.

• Provide research support to various internal business partners (i.e. Compliance, Internal Audits, Litigation & Subpoena, Appeals & Grievance) for internal and regulatory audits, enforcement matters and regulatory complaints, as requested.