Healthcare Policy Team Lead
Core
Leads the identification, interpretation, and implementation of policy requirements governing Exchange review and audit activities, specifically for the Affordable Care Act and health insurance markets.
Role type
Senior IC healthcare policy team lead (regulatory compliance)
Builds
Review unit logic, scripts, and review tools for Exchange Improper Payment Measurement (EIPM) methodology
Domain
Healthcare / Insurance / Regulatory Compliance
Required skills
regulatory analysis, knowledge of Affordable Care Act (Federally Facilitated and State-Based Exchanges), team management, policy interpretation, stakeholder management
Preferred skills
navigating ambiguity, developing training on regulatory updates, proficiency working with compliance team members and developers
Technologies
review unit logic, scripts, review tools
Responsibilities
Leads a team of policy members, assigns responsibilities, sets priorities, and oversees quality; monitors federal and state policy changes and court rulings; directs assessments of how changes affect EIPM methodology; establishes policy interpretations for consistent application; coordinates with technical, review, and data teams to translate policy decisions into procedures and tools.
Seniority
Senior, hands-on IC with management responsibilities
