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RETIREDSelf-motivated, results oriented professional with progressive experience in the healthcare industry. Extensive experience with state and federal compliance, including the filing and approval of commercial benefits plans offered both on and off the Exchange with state and federal regulators. Well developed communication and problem solving skills with the ability to resolve difficult situations in a fast paced environment. Over 20 years of experience in managed healthcare industry, 17 years in compliance. Specialties: State and Federal Compliance - Healthcare Administration
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Commercial Compliance ConsultantProvidence Health & Services May 2018 - Mar 2023Beaverton, OregonProvidence Health & Services is the third largest not-for-profit health system in the United States, committed to providing for the needs of our communities, especially for those who are poor and vulnerable across Alaska, California, Montana, Oregon and Washington.• Evaluate new and existing state and federal laws and regulations in order to advise internal customers.• Analyze complex regulatory reporting and filing requirements related to the health plan’s legal obligations and new business initiatives.• Liaison with staff at the Oregon and Washington Insurance Commissioner's offices, and other state and federal regulators as appropriate.• Perform tasks that impacts PHP’s legal and regulatory obligations as well as financial obligations to commercial Providence Health Plan customers. -
Product Development ManagerCentene Corporation 2014 - 2017Portland, Oregon AreaCentene Corporation is a diversified, multi-national healthcare enterprise that provides a portfolio of services to government sponsored healthcare programs, focusing on under-insured and uninsured individuals. Many receive benefits provided under Medicaid, including the State Children's Health Insurance Program (CHIP), as well as Aged, Blind or Disabled (ABD), Foster Care and Long Term Care (LTC), in addition to other state-sponsored/hybrid programs, and Medicare (Special Needs Plans). • Manage the Product Development life cycle for the development, maintenance and enhancement of new and existing products, including the gathering of business and regulatory requirements and project management of the overall development timeline.• Ensure product benefits are compliant and align with corporate and health plan commercial strategy. • Communicate proposed regulations and legislative activity to stakeholders and provide feedback to lobbyists regarding potential impacts. • Organize and facilitate multi-disciplinary, cross-functional work teams as needed for federal and state regulatory review and dissemination of regulatory interpretations. • Create, update and file member contract materials to comply with current commercial regulatory requirements, and make revisions as needed based on any objections received from regulators during the filing process. • Coordinate commercial product filings and lead regulator engagement and outreach in both SERFF (state) and HIOS (federal) filing systems. -
Senior Compliance AnalystHealth Net 2008 - 2014Health Net, Inc. is one of the nation’s largest publicly traded managed health care companies that provides health benefits to approximately six million individuals through local health plans and government-sponsored managed care plans. • Review and analyze regulatory requirements for their impact on the health plan and audit compliance with new and existing laws. • Draft policies and procedures in response to changes to current laws and regulations or to implement new laws.• Assist in the preparation of materials for regulatory audits and coordinate responses for corrective action plans and reporting. • File all coverage documents, rates, annual statutory filings, and marketing materials with the Arizona Department of Insurance using SERFF. • File coverage documents with CMS in HIOS for the Federally Facilitated Exchange. • Facilitate meetings with company subject matter experts to assign and track responses to any objections received from regulators regarding filed materials. -
Compliance AnalystOxford Life Insurance Company 2006 - 2007Oxford Life Insurance Company is an insurance company focused on supporting the senior market with products that help meet their financial needs, with an emphasis on life insurance and annuities. • Compile, organize and file life, annuity and Medicare supplement insurance products, rates and related forms to all states for their review and approval using SERFF. • Develop and maintain administrative processes and procedures designed to organize company compliance activity and to track regulatory filings. • Conduct legal and regulatory research. -
Compliance Analyst IiiPacificare Health Systems / Unitedhealth Group 1997 - 2006• Manage and support regulatory compliance for Claims, Health Services, Membership Accounting, Network Management, Sales and Marketing operations. • Intra-company subject matter expert for state / federal compliance and legal questions. • Review physician contract language, Medical Management policy and procedures, and new products to assess company feasibility, and regulatory risk to managed care. • Provide ongoing collaboration and advisement to various executive management workgroups to ensure regulatory compliance. • Regulatory liaison between CMS and the Arizona Department of Insurance.
Steve Ruby Skills
Steve Ruby Education Details
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Photography -
Liberal Arts And Sciences, General Studies And Humanities
Frequently Asked Questions about Steve Ruby
What is Steve Ruby's role at the current company?
Steve Ruby's current role is Commercial Compliance Consultant, Providence Health & Services.
What is Steve Ruby's email address?
Steve Ruby's email address is st****@****nce.org
What is Steve Ruby's direct phone number?
Steve Ruby's direct phone number is +181867*****
What schools did Steve Ruby attend?
Steve Ruby attended Arizona State University, Phoenix College.
What are some of Steve Ruby's interests?
Steve Ruby has interest in Poverty Alleviation, Animal Welfare, Environment, Arts And Culture.
What skills is Steve Ruby known for?
Steve Ruby has skills like Medicare, Policy, Managed Care, Management, Medicaid, Provider Relations, Claim, Health Policy, Hmo, Ppo, Utilization Management, Network Development.
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Steve Ruby
Athens, Ga3jaguarlandrover.com, mbusa.com, carriertransicold.eu -
Steve Ruby
Asst. Professor Of Professional Practice At Oklahoma State University And Of Counsel At Baker, Ihrig And Corley, P.C.Oklahoma City Metropolitan Area -
Steve Ruby
Denver Metropolitan Area5yahoo.com, rubysolutions.com, mckinstry.com, mckinstry.com, mckinstry.com2 +120683XXXXX
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Steve Ruby
Attorney With Over Ten Years Of Professional Experience In Alcoholic Beverage Manufacturing, Sales, And Compliance.Greater Indianapolis2gmail.com, blackacrebrewing.com1 (317) 2XXXXXXX
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