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Organization TypePublic Interest
Years of Experience
Date Last Verified
ProfileDuties: Ensure compliance with contract requirements, review and submission deadlines, and required reporting are met. Direct all operational and administrative issues related to regulatory and government contracts related to Department of Insurance requirements; manage relationship with regulatory and department of insurance personnel, as applicable. Oversee all government contracts and regulatory requirements in all states applicable for the Health Insurance Exchange. Provide interpretation and recommendations to the organization in regard to regulatory requirements and government contract administration. Establish and maintain collaborative working relationship with state and federal regulators including advocacy on program requirements and supporting business development opportunities. Coordinate organizational participation in federal and state contract and regulatory audits and site visits. Coordinate all regulatory filings including annual required submissions and those which support new business development. Provide support to the organization in assessing, interpreting, and incorporating new and revised regulatory and government contract requirements into operations. Assist with oversight of delegated vendors, contract management, in accordance with federal and state regulatory requirements and government contracts. Report potential risks, non-compliance or alleged violations to the Compliance department Ensure policies and procedures are accurate and translate into actionable business decision Assist with product development for the Health Insurance Marketplace.
Qualification and Experience
Requirements: Bachelor of Science/Arts (BS/BA) degree in business or related field or equivalent work experience is required. Master of Business Administration (MBA), or related graduate degree or completion of an accredited JD degree is preferred. 3-5 years in a managed care organization is preferred. Intermediate proficiency level with Microsoft Office. Knowledge of the political and regulatory environments. Compliance and audit skills. Ability to prioritize and manage time in a fast moving environment. Decision making/problem solving skills. Negotiation skills/experience. Communication skills. Strong listening and thinking skills. Technical writing skills.
Requisition Number: 18-0211
P.O. Box 8738
Dayton, OH 45401-8738