Functional Program Analyst, Contracts Analyst
Core
Review and evaluate complex healthcare contract filings for compliance with Washington State insurance laws, federal regulations, and case law.
Role type
Functional Program Analyst (Contracts Analyst)
Builds
Compliant healthcare contracts for the Washington State insurance marketplace
Domain
Public sector / Healthcare Insurance / Regulatory Compliance
Deliverable
production ML models | product features | dashboards & analysis | research | client delivery | infrastructure | physical/clinical work
Required skills
Contract management, Legal document review, Regulatory compliance analysis, Healthcare benefit plan administration, Microsoft Excel, Microsoft Word, Microsoft Outlook, Resume and cover letter preparation, Credential evaluation
Preferred skills
Advanced Microsoft Excel, Advanced Microsoft Word, Advanced Microsoft Outlook, Workload organization, Timeline management, Deadline adherence
Technologies
Excel, Word, Outlook
Responsibilities
Independently review and evaluate complex healthcare contract filings for compliance with Washington State insurance laws, federal laws, regulations, and applicable case law; Interpret contract language and determine whether legal and regulatory standards are satisfied; Apply relevant RCWs, WACs, federal requirements, and case law to support consistent, legally sound review decisions; Identify compliance gaps, deficiencies, and provisions that do not meet regulatory expectations, then prepare clear recommendations or objections to bring contracts into compliance; Research issues and provide subject matter guidance to carriers, Health Care Benefit Managers, agents, attorneys, providers, pharmacies, Pharmacy Services Administrative Organizations, and consumers; Discuss contract provisions, interpret case law, and help resolve questions or concerns that arise during the review process; Collaborate with supervisor, program manager, and colleagues on issues that may affect the broader insurance marketplace and help maintain uniform review standards.
Seniority
Mid-level (6 years experience required)