Healthcare Policy Team Lead

Location: US - VA, McLean

Job Family

Risk & Regulatory Compliance Consulting

Travel Required

Up to 10%

Clearance Required

Ability to Obtain Public Trust

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

The annual salary range for this position is $113,000.00-$188,000.00. Compensation decisions depend on a wide range of factors, including but not limited to skill sets, experience and training, security clearances, licensure and certifications, and other business and organizational needs.

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 [email protected]. 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 [email protected]. 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 [email protected]. 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.

Additional Locations: US - TX, Austin, US - IL, Chicago, US - PA, Philadelphia, US - MD, Hanover, US - MA, Boston, US - CA, Los Angeles, US - GA, Atlanta