Issuer Operations Analyst - State Based Exchange

$70,000 - $77,000/Yr

State of Georgia - Atlanta, GA

Full-time - Mid Level

Atlanta, GA

Executive, Legislative, and Other General Government Support

About the position

The Issuer Operations Analyst plays a crucial role in ensuring the certification and compliance of Quality Health Plans (QHP) and Stand-Alone Dental Plans (SADP) sold through the Exchange and the Small Business Health Options Program (SHOP). This position involves developing and implementing policies, managing the certification process, and conducting compliance reviews to ensure adherence to federal and state regulations.

Responsibilities

• Responsible for certification and compliance of Quality Health Plans (QHP) and Stand-Alone Dental Plans (SADP).
• Develop and implement policies, application processes, timelines, data corrections, and certifications.
• Review data submissions and certification timeline bulletins to identify changes to policies or processes.
• Monitor the annual certification process for plans and conduct reviews of applications for compliance.
• Manage the annual auto re-enrollment process and communicate with health insurance carriers.
• Confirm completion and accuracy of health insurance carrier and plan information within the enrollment system.
• Perform periodic and targeted compliance reviews of health insurance carriers and plans.
• Develop corrective action plans for non-compliance of health insurance carrier plans.
• Maintain policies and operations of the Small Business Health Options Program.
• Process employer applications and provide eligibility determinations for coverage.
• Provide data reports to the Internal Revenue Service (IRS) upon request.
• Maintain records of enrollment reports in accordance with federal and state record retention policies.

Requirements

• High school diploma or GED.
• Four (4) years of job-related experience; or two (2) years of experience at the lower level Complnc Specialist 2 (RCP061) or position equivalent.
• Valid driver's license may be required.

Nice-to-haves

• Certification or licensure may be preferred for some positions.

Benefits

• Dental insurance