Key skills
Communication
About this role
Role Overview
- Negotiate with state and federal regulatory agencies to obtain policy and certificate approval for insurance products
- Support implementation and maintenance of compliant insurance policies and certificates
- Contribute to department strategy and make decisions on handling technical work for complex project components
- Develop and maintain group policy and certificate language to support product initiatives and regulatory requirements
- Create awareness of current regulatory issues and ensure compliance of policy forms
- Monitor and analyze regulatory requirements, providing consultative guidance
- Facilitate discussions with operational and compliance partners
- Prepare standard policy and certificate forms for regulatory filings
- Research and respond to regulatory objections and inquiries
- Conduct quality reviews for policy/certificate forms and other materials
- Recommend and support process improvements to maximize efficiency
- Serve as Subject Matter Expert (SME) for assigned product lines
- Conduct research and provide findings regarding contract language or competitor filings.
Requirements
- Bachelor's Degree or equivalent experience in a healthcare/insurance compliance function
- Minimum 5 years of healthcare / insurance industry experience
- Knowledge of laws and regulations governing the healthcare / insurance industry experience, such as state Departments of Insurance and CMS
- Ability to research and analyze state laws and regulations
- Understanding of insurance products, including policy/certificate language
- Proficient in Adobe Acrobat and Microsoft 365 (Office) applications, including Word, Excel, Teams, and SharePoint
- Excellent oral and written communication skills
- Demonstrated attention to detail and accuracy
- Proven analytical and problem-solving ability
- Self-motivated and task oriented, with an ability to manage multiple priorities and work under pressure to meet deadlines.
Benefits
- Medical, dental and vision benefits
- 401(k) retirement savings plan
- Time off (including paid time off, company and personal holidays, paid parental and caregiver leave)
- Short-term and long-term disability
- Life insurance and many other opportunities