Regulatory Analyst Regulatory Filings

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Regulatory Analyst (Regulatory Filings)
The candidate performs regulatory filings for the commercial markets and performs research. Performs formal regulatory filings seeking approval of new products, service area expansions, new benefit policies and others; guide special projects; provide regulatory interpretation; perform reporting; and develop and implement auditing and monitoring strategies. Responds to external requests for information required by the organization for its regulatory filings. Performs regulatory filings in SERFF and HIOS. Respond to inquiries from state and federal regulatory agencies. Monitors pending legislation and regulations affecting company services. Maintains database and other reference materials related to legislative and regulatory issues and compliance. Communicates state and federal requirements to internal and external clients. Provides development guidance and assists in the identification, implementation, and maintenance of compliance policies, procedures and work instructions. Assists in the identification, analysis, and resolution of compliance issues. Maintains and reviews regulatory documentation necessary to maintain corporate standards. Performs periodic compliance audits, risk assessments and conducts related ongoing compliance monitoring activities. Assists health plans in managing relationships with regulatory agencies and seeks to resolve policy issues which may negatively impact service to members. Serves as a company wide resource and liaison on policies, contract issues and provisions, communications, workflow, and quality improvements. Bachelor's degree in related field or equivalent experience is required. Master's or J.D. degree is preferred and may be considered in lieu of experience. Must have 1+ year of related experience in compliance, privacy and/or regulatory affairs. Working knowledge of laws and/or regulations in area of compliance - in particular HIPAA, and state regulations - is required.

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