MedPro Group’s mission is built on a century-old legacy of protecting those who protect others. From our roots in our hometown of Fort Wayne, Indiana, we've worked diligently to become the nation's premier healthcare liability coverage provider, currently insuring more than 300,000 customers. With that growth, we've built a significant presence in all 50 states. Our team works across the country to provide the best strategies to mitigate risk and preserve the reputations of those who have entrusted their good name to us. That passion – built on a foundation of a culture that values uncompromised integrity, obsessive client focus, great teamwork, and a long-term mindset – make MedPro a preferred employer that many call their career home. General: MedPro Group is an Equal Opportunity Employer. The annual gross base salary range is $93,040 to $130,000. This range anticipates the low and high end of the salary for this position. Actual salaries will vary and are based on factors such as a candidate’s qualifications, skills and competencies. Salary is one component of MedPro’s total compensation and benefits package. For a more detailed overview, visit our careers website at www.medpro.com/careers.
Regulatory & Provider Network Filing Analyst
Location
United States
Posted
53 days ago
Salary
$60K - $80K / year
Seniority
Mid Level
No structured requirement data.
Job Description
Regulatory & Provider Network Filing Analyst
MedPro Group
Role Description The Regulatory & Provider Network Filing Analyst is responsible for preparing and submitting Wellfleet's student health insurance network filings and reports. This role involves ensuring that regulatory submissions are timely, complete, and accurate. The position requires oversight and coordination with internal and external stakeholders and the ability to understand and apply relevant laws and regulations. - Serve as a subject matter expert (SME) in provider network regulations, accreditation requirements, network adequacy standards, and other new and existing laws pertaining to provider networks. - Implement and enforce best practices and policies, ensuring alignment with department and organizational goals. - Perform a detailed review of new legal and regulatory guidance to identify and implement any necessary changes. - Track regulatory submission deadlines, and proactively coordinate with external and internal stakeholders to prepare filings in advance of deadlines. - Oversee network filings and reports from inception to completion, ensuring that all submissions are accurate, well-written, and timely. - Regularly monitor open submissions to ensure timely and accurate responses to any objections or requests for additional information. - Support the review and development of written responses for network submissions and responses to objections, as needed, and validate data to ensure accurate reporting. - Ensure all regulatory filings and reporting deadlines are met. - Implement and enforce best practices and assist with ad hoc projects to achieve departmental or organizational goals. - Collaborate with internal and external stakeholders to perform network oversight, and develop and monitor corrective action plans, as needed. - Perform other duties as assigned. Qualifications - Bachelor’s degree in healthcare administration or related field, and 2+ years of health insurance experience, or a combination of education and experience. - Compliance and/or network experience preferred. - SERFF filing system experience preferred. - Ability to work effectively with internal and external stakeholders. - Ability to interpret and apply state and federal laws and regulations. - Familiarity with provider network regulations, accreditation requirements, and NCQA standards preferred. - Excellent written communication and interpersonal skills. - Strong organizational skills and the ability to manage competing priorities. - Proficiency with MS Office products including Outlook, Word and Excel. - Demonstrates a strong commitment to compliance and ethics. - Self-motivated with the ability to work independently, with very little supervisory direction. Benefits - Competitive compensation package. - Comprehensive benefits package including life, health and dental, vision, 401K retirement plan. - Short- and long-term disability coverage. - Flexible/dependent care spending account. - Tuition reimbursement. - Business casual dress.
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