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Functional Program Analyst 3 - HCBM Analyst
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Job Description
- Req#: 5201345
Employer Industry: Government - Insurance Regulation
Why consider this job opportunity:
- Salary up to $6,906.00 monthly
- Comprehensive benefits package including health, dental, vision, and retirement
- Flexible work environment with telework opportunities
- Supportive work culture that values diversity and professional growth
- Training and development programs including tuition reimbursement and Public Service Loan Forgiveness
- Opportunity to make a meaningful impact on consumer protection in the insurance market
What to Expect (Job Responsibilities):
- Independently analyze and evaluate Health Care Benefit Manager (HCBM) and related contracts for compliance with state and federal laws
- Review complex contractual documents to ensure legal and regulatory standards are met
- Interpret contract provisions governing prior authorization, medical necessity, and claims processing
- Identify compliance issues and develop recommendations for corrective actions
- Collaborate with colleagues to ensure consistency in review standards and address broader marketplace issues
What is Required (Qualifications):
- Six (6) years of professional work experience in contract management, regulatory compliance, or health care benefit administration
- A degree in public administration, business administration, law, finance, or a related field may substitute for relevant experience
- Intermediate-level skills in Microsoft Outlook, Word, and Excel
- Ability to interpret and apply relevant laws and regulations
- Strong analytical and communication skills
How to Stand Out (Preferred Qualifications):
- Advanced skills and experience in Microsoft Outlook, Excel, and Word
- Demonstrated ability to organize work, establish timelines, and meet deadlines
- Experience in health care benefit plan design or regulatory examinations
#InsuranceRegulation #PublicService #ConsumerProtection #CareerOpportunity #DiversityAndInclusion
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