Job Family:

Travel Required:

Clearance Required:

What You Will Do:

The Healthcare Review/Audit Policy Lead leads the identification, interpretation, and implementation of policy requirements that govern Exchange review and audit activities. Leads a team of multiple policy team members, assigning responsibilities, setting priorities, and overseeing the quality and timely completion of their work. Monitors federal and state policy changes, court rulings, annual Exchange regulations, sub-regulatory guidance, and system and operations documentation affecting Advance Premium Tax Credit (APTC) eligibility, Qualified Health Plan (QHP) eligibility, and Special Enrollment Periods (SEPs). Directs assessments of how these changes affect Exchange Improper Payment Measurement (EIPM) methodology, establishes policy interpretations for consistent application by reviewers, and oversees required updates to review unit logic, scripts, and review tools. Leads the development and quality review of policy update deliverables, resolves or elevates policy questions, and coordinates with technical, review, and data teams to translate policy decisions into accurate, consistent review procedures and tools.

What You Will Need:

• Bachelor’s degree
• FIVE (5) + years of relevant experience, at least 2 in a management capacity
• Experience with regulatory analysis
• Experience working in or knowledge of the Affordable Care Act, specifically Federally Facilitated Exchanges, State-Based Exchanges and health insurance markets and exchanges
• Ability to oversee multiple concurrent workstreams
• Excellent communication skills (verbal and written)
• Strong stakeholder management skills and experience

What Would Be Nice To Have:

• 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

What We Offer:

Guidehouse offers a comprehensive, total rewards package that includes competitive compensation and a flexible benefits package that reflects our commitment to creating a diverse and supportive workplace.

Benefits include:

• 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 PayDown

• 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 for 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.

If you have visited our website for information about employment opportunities, or to apply for a position, and you require an accommodation, please contact Guidehouse Recruiting at 1-571-633-1711 or via email at RecruitingAccommodation@guidehouse.com. All information you provide will be kept confidential and will be used only to the extent required to provide needed reasonable accommodation.

All communication regarding recruitment for a Guidehouse position will be sent from Guidehouse email domains including @guidehouse.com or guidehouse@myworkday.com.  Correspondence received by an applicant from any other domain should be considered unauthorized and will not be honored by Guidehouse.  Note that Guidehouse will never charge a fee or require a money transfer at any stage of the recruitment process and does not collect fees from educational institutions for participation in a recruitment event. Never provide your banking information to a third party purporting to need that information to proceed in the hiring process.

If any person or organization demands money related to a job opportunity with Guidehouse, please report the matter to Guidehouse’s Ethics Hotline. If you want to check the validity of correspondence you have received, please contact recruiting@guidehouse.com. Guidehouse is not responsible for losses incurred (monetary or otherwise) from an applicant’s dealings with unauthorized third parties.

Guidehouse does not accept unsolicited resumes through or from search firms or staffing agencies. All unsolicited resumes will be considered the property of Guidehouse and Guidehouse will not be obligated to pay a placement fee.