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Regulatory Filing Specialist

2 months ago

Oakland, California, United States Blue Shield Of California Full time
About the Role

We are seeking a highly skilled Regulatory Filing Analyst to join our Government Programs Regulatory Law team. As a key member of our team, you will play a critical role in supporting the Medi-Cal and Medicare Advantage lines of business.

Key Responsibilities
  • Assist with complex Department of Managed Health Care (DMHC) filings and provide regulatory guidance to the business on state and federal requirements.
  • Work directly with the Compliance Team on regulatory audits and maintain a filing tracker to ensure compliance with regulatory agencies.
  • Collaborate with internal business units to write/edit the description of packaged filings for accurate representation of the company's proposals to the regulatory agencies for approval.
  • Independently manage and lead health plan responses to Department of Managed Health Care (DMHC) inquiries and complex filings.
Requirements
  • Requires a college degree or equivalent experience and minimum 5 years of prior relevant experience.
  • Requires advanced knowledge of job area typically obtained through advanced education combined with experience.
  • Requires strong analytical and problem-solving skills.
  • Requires knowledge of the Knox Keene Act.
  • Knowledge of Medi-Cal and/or Medicare Advantage is strongly desired.
About Blue Shield of California

Blue Shield of California's mission is to ensure all Californians have access to high-quality health care at a sustainably affordable price. We are transforming health care in a way that genuinely serves our nonprofit mission by lowering costs, improving quality, and enhancing the member and physician experience.

We strive to make a positive change across our industry and communities. Our values include being Honest, Human, and Courageous. We are committed to creating a diverse, equitable, and inclusive environment where all employees can be their authentic selves and fully contribute to meet the needs of the multifaceted communities we serve.