Regulatory Analyst

Role Overview

The Regulatory & Provider Network Filing Analyst is responsible for preparing and submitting Wellfleet’s student health insurance provider network filings and reports. You ensure regulatory submissions are timely, complete, and accurate, and you coordinate with internal and external stakeholders to apply relevant laws and regulations.

Responsibilities

• Act as a subject matter expert (SME) in provider network regulations, accreditation requirements, network adequacy standards, and related laws.
• Review new legal/regulatory guidance and determine what changes are required.
• Track submission deadlines and coordinate proactively to prepare filings ahead of due dates.
• Oversee network filings and reports end-to-end (from inception to completion), ensuring submissions are accurate, well-written, and timely.
• Monitor open submissions and respond to objections or requests for additional information in a timely and accurate manner.
• Draft and validate written responses to submission objections, including data validation for accurate reporting.
• Ensure all regulatory filing and reporting deadlines are met.
• Enforce best practices and support ad hoc projects, including corrective action plan support as needed.
• Collaborate with internal/external stakeholders for network oversight and corrective actions.

Requirements

• Bachelor’s degree in healthcare administration (or related field) and 2+ years of health insurance experience, or an equivalent combination of education and experience.
• Ability to interpret and apply state and federal laws/regulations.
• Ability to work effectively with internal and external stakeholders.
• Strong written communication, interpersonal, organizational, and prioritization skills.
• Proficiency with MS Office: Outlook, Word, Excel.
• Strong commitment to compliance and ethics and ability to work independently with minimal supervision.

Preferred

• Compliance and/or network experience.
• SERFF filing system experience.
• Familiarity with provider network regulations, accreditation requirements, and NCQA standards.