Senior Consultant - Public Health - Healthcare Review​/Audit Policy

Healthcare Review/Audit Policy Member

The Healthcare Review/Audit Policy Member is responsible for monitoring federal/state policy changes and court rulings relevant to the Exchanges (e.g., changes impacting the Advanced Premium Tax Credit (APTC)/Qualified Health Plan (QHP) eligibility, and Special Enrollment Periods (SEPs), and through reviewing annual Exchange regulations, sub-regulatory guidance, and system/operations documentation;
Assesses the impact of those changes on Exchange Improper Payment Measurement (EIPM) methodology, including review unit logic, scripts, and review tools, and determines where updates are required;
Develops policy update deliverables and coordinates with technical, review, and data teams to accurately reflect changes.

What You Will Need:

• Bachelor's degree
• 3-5+ years of relevant experience
• Experience working in or knowledge of the Affordable Care Act, specifically State-Based Exchanges, Federally-Facilitated Exchanges, and health insurance markets and exchanges
• Ability to oversee multiple concurrent work streams
• Excellent communication skills (verbal and written)
• Strong stakeholder management skills and experience

What Would Be Nice To Have:

• Experience with regulatory analysis
• Ability to navigate ambiguity and provide clear guidance, direction, and structure to the team
• Flexibility and agility to respond to changing requirements in a dynamic environment
• Skills to develop training on regulatory updates and train team members on the impact of the changes
• Proficiency working with compliance team members and developers to confirm that regulatory changes are properly reflected in testing methodology and automation scripts

The annual salary range for this position is $98,000.00-$. Compensation decisions depend on a wide range of factors, including but not limited to skill sets, experience and training, security clearances, licensure and certifications, and other business and organizational needs.

What We Offer :

• Medical, Rx, Dental & Vision Insurance
• Personal and Family Sick Time & Company Paid Holidays
• Position may be eligible for a discretionary variable incentive bonus
• Parental Leave and Adoption Assistance
• 401(k) Retirement Plan
• Basic Life & Supplemental Life
• Health Savings Account, Dental/Vision & Dependent Care Flexible Spending Accounts
• Short-Term & Long-Term Disability
• Student Loan Pay Down
• Tuition Reimbursement, Personal Development & Learning Opportunities
• Skills Development & Certifications
• Employee Referral Program
• Corporate Sponsored Events & Community Outreach
• Emergency Back-Up Childcare Program
• Mobility Stipend

About Guidehouse

Guidehouse is an Equal Opportunity Employer Protected Veterans, Individuals with Disabilities or any other basis protected by law, ordinance, or regulation.

Guidehouse will consider employment qualified applicants with criminal histories in a manner consistent with the requirements of applicable law or ordinance including the Fair Chance Ordinance of Los Angeles and San Francisco.