Senior Insurance Product Compliance Professional
DescriptionThe Senior Insurance Product Compliance Professional Performs consultation and research for policy & certificate language development.
The Senior Insurance Product Compliance Professional work assignments involve moderately complex to complex issues where the analysis of situations or data requires an in-depth evaluation of variable factors.
ResponsibilitiesThe Senior Product Compliance Professional creates awareness of current regulatory issues and ensures compliance of new and existing Commercial group fully-insured product policies and certificates.
Makes decisions on moderately complex to complex issues regarding technical approach for project components, and work is performed without direction.
Exercises considerable latitude in determining objectives and approaches to assignments.
Key responsibilities are as follows:
Monitor and analyze regulatory requirements to assess contract language impacts or provide consultative guidance to other associates within the teamWrite standard group contract language for Commercial specialty (eg, Dental, Vision, Life) policies and certificates to support product initiatives, administrative practices, and applicable regulatory requirementsFacilitate discussions with operational and compliance partners to review and finalize drafted contract language and assist with state filings along with negotiating regulatory approvalsPrepare standard policy and certificate forms for use as templates for state and federal regulatory filings and subsequent implementationResearch and develop written responses to, or provide consultative support for, regulatory objections; exams; and inquiriesAssist with product review and creation, filing, and implementation of single case/custom group formsMaintain accurate and thorough documentation regarding the rationale for new or revised contract languageConduct peer to peer quality reviewsRecommend and support process improvements to maximize efficiencyReview and provide revisions for marketing material for all specialty lines of business (generic, state-specific, and single case/custom materials)Consult on application filings issues and coordinate filing of applications for Commercial groupServe as subject matter expert for all specialty lines of business, triaging and answering compliance related questions regarding policy and certificate language, as well as conducting any research that is requestedServe as a System for Electronic Rate and Form Filing (SERFF) administrator and facilitate monthly fee reportingRequired QualificationsBachelor's Degree or equivalent experience in a compliance functionMinimum 4 years of healthcare / insurance industry experienceKnowledge of laws and regulations governed by state Departments of InsuranceProficient in Microsoft Office applications, including Word, Excel and PowerPointExcellent oral and written communication skills, with ability to interact effectively with associates across all levels of the organizationDemonstrated attention to detail and accuracyProven analytical and problem solving abilitySelf-motivated and task oriented with an ability to manage multiple priorities and work under pressure to meet deadlinesMust be passionate about contributing to an organization focused on ensuring compliance and continuously improving consumer experiencesPreferred QualificationsAuditing or consulting experienceProject coordination or project management experienceExperience with filings in SERFFReport and presentation development experienceAbility to effectively interact with reviewer-level state/federal regulatorsAdditional InformationFor this job, associates are required to be fully COVID vaccinated or undergo weekly COVID testing and wear a face covering while at work.
The weekly testing will need to be done through an approved Humana vendor, and unvaccinated associates should follow all social distancing and masking protocols if they are required to come into a Humana facility or work outside of their home.
We are ahealthcarecompany committed to putting health and safety first for our members, patients, associates, and the communities we serve.
If progressed to offer, you will be required to:
Provide proof of full vaccination ORCommit to weekly testing, following all CDC protocols, ORProvide documentation for a medical or religious exemption consideration.
This policy will not supersede state or local laws.
Requests for these exemptions should be submitted at least 2 weeks prior to your scheduled first day of work.
Scheduled Weekly Hours40.
Estimated Salary: $20 to $28 per hour based on qualifications.
The Senior Insurance Product Compliance Professional work assignments involve moderately complex to complex issues where the analysis of situations or data requires an in-depth evaluation of variable factors.
ResponsibilitiesThe Senior Product Compliance Professional creates awareness of current regulatory issues and ensures compliance of new and existing Commercial group fully-insured product policies and certificates.
Makes decisions on moderately complex to complex issues regarding technical approach for project components, and work is performed without direction.
Exercises considerable latitude in determining objectives and approaches to assignments.
Key responsibilities are as follows:
Monitor and analyze regulatory requirements to assess contract language impacts or provide consultative guidance to other associates within the teamWrite standard group contract language for Commercial specialty (eg, Dental, Vision, Life) policies and certificates to support product initiatives, administrative practices, and applicable regulatory requirementsFacilitate discussions with operational and compliance partners to review and finalize drafted contract language and assist with state filings along with negotiating regulatory approvalsPrepare standard policy and certificate forms for use as templates for state and federal regulatory filings and subsequent implementationResearch and develop written responses to, or provide consultative support for, regulatory objections; exams; and inquiriesAssist with product review and creation, filing, and implementation of single case/custom group formsMaintain accurate and thorough documentation regarding the rationale for new or revised contract languageConduct peer to peer quality reviewsRecommend and support process improvements to maximize efficiencyReview and provide revisions for marketing material for all specialty lines of business (generic, state-specific, and single case/custom materials)Consult on application filings issues and coordinate filing of applications for Commercial groupServe as subject matter expert for all specialty lines of business, triaging and answering compliance related questions regarding policy and certificate language, as well as conducting any research that is requestedServe as a System for Electronic Rate and Form Filing (SERFF) administrator and facilitate monthly fee reportingRequired QualificationsBachelor's Degree or equivalent experience in a compliance functionMinimum 4 years of healthcare / insurance industry experienceKnowledge of laws and regulations governed by state Departments of InsuranceProficient in Microsoft Office applications, including Word, Excel and PowerPointExcellent oral and written communication skills, with ability to interact effectively with associates across all levels of the organizationDemonstrated attention to detail and accuracyProven analytical and problem solving abilitySelf-motivated and task oriented with an ability to manage multiple priorities and work under pressure to meet deadlinesMust be passionate about contributing to an organization focused on ensuring compliance and continuously improving consumer experiencesPreferred QualificationsAuditing or consulting experienceProject coordination or project management experienceExperience with filings in SERFFReport and presentation development experienceAbility to effectively interact with reviewer-level state/federal regulatorsAdditional InformationFor this job, associates are required to be fully COVID vaccinated or undergo weekly COVID testing and wear a face covering while at work.
The weekly testing will need to be done through an approved Humana vendor, and unvaccinated associates should follow all social distancing and masking protocols if they are required to come into a Humana facility or work outside of their home.
We are ahealthcarecompany committed to putting health and safety first for our members, patients, associates, and the communities we serve.
If progressed to offer, you will be required to:
Provide proof of full vaccination ORCommit to weekly testing, following all CDC protocols, ORProvide documentation for a medical or religious exemption consideration.
This policy will not supersede state or local laws.
Requests for these exemptions should be submitted at least 2 weeks prior to your scheduled first day of work.
Scheduled Weekly Hours40.
Estimated Salary: $20 to $28 per hour based on qualifications.
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