Regulatory Analyst, Sr

Job description

Position Summary: The Sr. Regulatory Analyst will communicate with Information Technology (IT), Heritage Provider Network Clinical Services (HPN CS) and other departments within the organization to become an expert on Regulatory Health Plan Utilization Management (UM) correspondence templates for all lines of businesses. The Senior Analyst will also serve as a mentor and will monitor the workflow of the Analyst I as well as serve as the oversight with the letter testing process. Essential Duties and Responsibilities include the following: - Perform secondary reviews of letter testing conducted by Analyst I, ensuring adherence to departmental procedures. - Assist in and ensure accuracy and timeliness of SharePoint uploads through secondary review processes. - Act as a mentor and participate in training initiatives for Analyst I. - Examine letters returned from HPN with errors, and coordinate with IT and Analyst I for necessary corrections. - Coordinate the finalization and submission of letter templates to HPN Corporate. - Oversee the management of pending letters in HPN’s Smartsheet for assigned health plans. - Manage and maintain the P Drive, ensuring it is up-to-date with current...