Senior Analyst Regulations Strategies amp Contracts

Profile

Senior Analyst, Regulations Strategies & Contracts

The candidate manages, creates & maintains client relationships. In adherence with the KPIC Regulatory and Strategy work platform (or similar department work platforms), fosters comprehensive compliance management through a series of activities to ensure that insurance contracts; advertising and marketing materials; disclosure requirements and other ancillary insurance forms are in compliance with applicable regulations, statutes and KPIC's contractual obligations. Series of Activities, under the leadership of more senior team members, include: Planning: identifying and may lead in the identification of regulatory and contractual accountabilities; may lead in the development of work and audit plans; participate and may lead regulatory-related work groups. Implementing: participating and may lead in the identification of regulatory and contractual requirements and conducting portions of related analyses, participating and may lead in the creation, development or revision of contract standards, templates, review and approval of forms ; policy and procedures ; monitor adherence to regulatory and contractual requirements and KPIC Policy&Procedures; prepares reports on compliance efforts and programs; Validating: reviewing regulatory and contractual requirements including participating and may lead in risk assessments and/or audits and participating and may lead in the investigation of instances of reported non compliance. participate and may lead in providing subject matter expertise and support on contracts®ulatory compliance on both a pre-sale and post implementation phase. Issue Resolution: Works and may lead, collaboratively with regional health plans and KPIC management to proactively identify and resolve potential issues and problems. Continuous Product&Service Improvements. Participate, contribute and may lead to new and innovative product development including contract and plan document features. Responsible for the filing of Insurance contracts with the regulators. Researches and stays abreast of regulations, statutes and industry standards. Determines impacts of implementation of new regulations and statutes and required notifications, changes and training. Supports RFP process by assisting or may lead in the drafting of boilerplate responses as well as responding to ad hoc questions and requests. Participate in meetings with major brokers/consultants and prospective clients by providing subject matter expertise for self-funding contracts and plan materials. Minimum five (5) years of health care regulatory compliance and filing, contract writing, health care operations; legal research; or insurance/health plan governance experience.Education- Bachelor's or legal degree, OR four (4) years of experience in a directly related field.- High School Diploma or General Education Development (GED) required. Thorough knowledge of health care regulatory policies practices and systems. Frequent use and or application of basic regulatory compliance principles, theories and concepts. General application of health care industry practices and standards, analysis and reports. Thorough writing skills in the following areas: health insurance contracts including group contracts, certificates of insurance and schedules of coverage, Through knowledge of insurance products. Must be able to work in a Labor/Management Partnership environment. Paralegal or law degree preferred.

Additional Information

Job ID: 1108730.

Company info

Kaiser Permanente
One Kaiser Plaza 8th Floor
Oakland
California
United States 94612
Website : http://www.kaiserpermanente.org