Regulatory Operations Business Analyst III (Health Insurance)

Location: Fully remote within the continental United States; applicants must be authorized to work in the U.S. without current or future employment-based visa sponsorship.

Salary: $70,100–$126,200 per year.

Company

hirify.global provides healthcare services focused on connecting people with accessible care and improving health outcomes.

What you will do

• Prepare and oversee Qualified Health Plan (QHP) templates and formal regulatory filing documents for individual commercial marketplace plans submitted through HIOS and SERFF.
• Audit QHP documents and complex data inputs for accuracy, compliance, and alignment with product intent.
• Coordinate with Sources of Truth document owners and cross-functional teams on QHP templates, policy forms, and filing requirements.
• Analyze proposed and enacted legislation and regulatory orders, communicate impacts and risks, and lead implementation of applicable changes.
• Maintain and improve department policies, procedures, and work processes while coordinating internal projects as a subject matter expert.
• Lead employee onboarding and analyst training, maintain training materials, and support relationships with DOI and CMS.

Requirements

• Bachelor’s degree in Business, Communications, Health Care, Political Science, or equivalent experience.
• 4+ years of business process or data analysis experience in health insurance, legal, compliance, or a related area.
• Ability to prepare, audit, interpret, and coordinate regulatory filing documentation and QHP-related data.
• Ability to analyze legislation, regulatory orders, application instructions, risks, and root causes.
• Ability to collaborate across functions, lead meetings and projects, train analysts, and communicate with regulatory agencies.
• U.S. work authorization without the need for employment-based visa sponsorship now or in the future.

Nice to have

• Experience in commercial health insurance and/or behavioral health managed care.
• Experience drafting and auditing filing documentation such as Summary of Benefit Coverage and Schedule of Benefits.
• Experience with QHP templates, including Plans and Benefit, Pharmacy, and Crosswalk templates.
• Experience auditing databases or QHP filing documentation.
• Knowledge of SERFF and/or HIOS systems.

Culture & Benefits

• Work is fully remote within the continental United States.
• Benefits include health insurance, 401(k), stock purchase plans, tuition reimbursement, paid time off, and holidays.
• Flexible work approaches may include remote, hybrid, field, or office schedules depending on the position and eligibility.
• Equal opportunity employment and consideration in accordance with applicable law.