Senior Insurance Product Compliance Professional

This is a fully remote position, open to applicants in United States.

📋 Description

• Oversee the annual submission process for On-Exchange (ACA) forms, templates, and supporting documentation related to Qualified Dental Plan certification activities.

• Monitor and evaluate both state and federal regulatory requirements, assessing their impact on contract language.

• Offer consultative advice to team members on regulatory mandates.

• Coordinate legislative updates across Group and Individual products.

• Collaborate with teams on requirements that influence existing products, new offerings, and product refresh initiatives.

• Raise awareness of regulatory concerns and confirm compliance for both new and existing policies and associated forms.

• Draft generic and state-specific contract language for Individual Specialty policies.

• Facilitate the review and finalization of contract language, assisting with negotiations for regulatory approvals.

• Investigate and develop responses to regulatory objections, audits, and inquiries.

• Maintain documentation that supports the rationale behind new or modified contract language.

• Conduct quality assessments of generic and state-specific policy forms.

• Act as a subject matter expert for assigned Specialty lines of business and related topics.

• Manage and respond to compliance inquiries related to policy and certificate language.

• Assist Professional 2s in drafting state forms and comprehending filing requirements.

• Ensure that project tracking information is accurate and up-to-date.

• Support product filings, which include drafting, filing, and implementing production forms along with annual On-Exchange product filings/binders.

• Recommend and facilitate process enhancements.

• Draft or contribute to work instructions and process documentation.

• Provide training and support to associates.

• Prepare standard policy forms for regulatory submissions and implementation.

• Consult on application filing issues and coordinate applications for Individual Specialty products.

• Conduct or assist with research requests.

• Carry out other assigned responsibilities.

⛳️ Requirements

• Bachelor's Degree or equivalent experience in a healthcare/insurance compliance role.

• At least 5 years of experience in the healthcare/insurance industry.

• Familiarity with laws and regulations governing the healthcare/insurance sector, including state Departments of Insurance and CMS.

• Capability to research and analyze state laws and regulations.

• Understanding of insurance products, including policy language.

• Proficient in Adobe Acrobat and Microsoft 365 applications, such as Word, Excel, Teams, and SharePoint.

• Excellent verbal and written communication abilities.

• Ability to work collaboratively with associates at all organizational levels and with state/federal regulators at the reviewer level.

• Strong attention to detail and accuracy.

• Proven analytical skills and problem-solving capabilities.

• Self-motivated and task-oriented, able to manage multiple priorities and work under pressure to meet deadlines.

• Dedicated workspace at home free from interruptions to safeguard member PHI/HIPAA information.

• Home internet service with a minimum speed of 25 Mbps for downloads and 10 Mbps for uploads.

• Experience in auditing or consulting is preferred.

• Preferred experience in project coordination or project management.

• Familiarity with SERFF is preferred.

• Preferred experience with the annual On-Exchange ACA form/template submission process and HIOS systems.

• Experience with stand-alone Dental and Vision insurance products is preferred.

• Preferred experience in creating and delivering reports and presentations.

🏝️ Benefits

• Bonus incentive plan.

• Medical benefits.

• Dental benefits.

• Vision benefits.

• 401(k) retirement savings plan.

• Paid time off.

• Company holidays.

• Personal holidays.

• Paid parental leave.

• Paid caregiver leave.

• Short-term disability.

• Long-term disability.

• Life insurance.

• Remote work arrangement.

• Dedicated work-from-home space.

• Internet service meeting minimum speed requirements.