Regulatory Operations Analyst III – Medicaid

This is a fully remote position, open to applicants in Oregon.

📋 Description

• Review, interpret, and summarize both proposed and enacted legislation along with regulatory updates.

• Conduct state and federal policy research, as well as monitor regulatory changes.

• Assist in achieving formal regulatory approval for designated products.

• Identify, analyze, and interpret legislation while communicating findings to relevant departments.

• Perform independent risk assessments, focusing on impacts to business applications and downstream outputs.

• Maintain databases and reference materials related to legislative and regulatory matters and compliance.

• Lead the regulatory interpretation of assigned product rules and regulations.

• Offer guidance to the business as new regulations arise.

• Track proposed modifications to Oregon Administrative Rules and keep subject matter experts informed.

• Participate in Rule Advisory Committees and assist with written feedback submissions to the Oregon Health Authority.

• Serve as the business owner for the Regulatory Legislation Implementation process.

• Aid in the annual contract restatement process from proposal through finalization and implementation.

• Monitor contract changes, attend meetings, track implementation status, and escalate risks as needed.

• Analyze contract amendments throughout the year.

• Support Oregon Health Plan contractor workgroups, meetings, and Requests for Information.

• Contribute to monthly Division of Financial Regulation meetings and manage follow-ups and communications.

• Evaluate objections related to regulatory interpretation and lead the drafting of responses to regulators.

• Collaborate with cross-functional teams as required.

• Adhere to all policies and standards.

• Perform additional duties as assigned.

⛳️ Requirements

• Bachelor's Degree in Business, Communications, Healthcare, Political Science/Pre-Law, or equivalent experience is required.

• A minimum of 4 years of experience in health insurance, legal, compliance, or a related field is required.

• Proven ability to build and maintain effective working relationships with state regulators, especially the Oregon Health Authority (OHA).

• Strong technical understanding of Medicaid policy, administrative rules, and regulatory guidance.

• Exceptional attention to detail and robust organizational skills.

• Ability to translate complex regulatory and policy jargon into clear, plain-language guidance and actionable recommendations.

• Demonstrated ability to advocate for regulatory clarifications or changes.

• Strong compliance mindset with experience in aligning organizational practices with regulatory and contractual requirements.

• Experience in reviewing regulations and providing interpretations using audience-appropriate terminology is preferred.

• Background in commercial health insurance and/or behavioral health managed care is preferred.

• A Master's Degree in a related field or a Juris Doctorate degree may be considered in lieu of experience.

• Candidates must reside in the State of Oregon.

🏝️ Benefits

• Competitive pay.

• Health insurance.

• 401K.

• Stock purchase plans.

• Tuition reimbursement.

• Paid time off in addition to holidays.

• Flexible work arrangements including remote, hybrid, field, or office schedules.

• Additional forms of incentives may be included in total compensation.

• Equal opportunity employer committed to diversity.