Senior Insurance Product Compliance Professional

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Job Information
Humana
Senior Insurance Product Compliance Professional
in
Dover
Delaware
Description
The 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.
Responsibilities
The 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 team
Write standard group contract language for Commercial specialty (e.g., Dental, Vision, Life) policies and certificates to support product initiatives, administrative practices, and applicable regulatory requirements
Facilitate discussions with operational and compliance partners to review and finalize drafted contract language and assist with state filings along with negotiating regulatory approvals
Prepare standard policy and certificate forms for use as templates for state and federal regulatory filings and subsequent implementation
Research and develop written responses to, or provide consultative support for, regulatory objections; exams; and inquiries
Assist with product review and creation, filing, and implementation of single case/custom group forms
Maintain accurate and thorough documentation regarding the rationale for new or revised contract language
Conduct peer to peer quality reviews
Recommend and support process improvements to maximize efficiency
Review 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 group
Serve 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 requested
Serve as a System for Electronic Rate and Form Filing (SERFF) administrator and facilitate monthly fee reporting
Required Qualifications
Bachelor's Degree or equivalent experience in a compliance function
Minimum 4 years of healthcare / insurance industry experience
Knowledge of laws and regulations governed by state Departments of Insurance
Proficient in Microsoft Office applications, including Word, Excel and PowerPoint
Excellent oral and written communication skills, with ability to interact effectively with associates across all levels of the organization
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
Must be passionate about contributing to an organization focused on ensuring compliance and continuously improving consumer experiences
Preferred Qualifications
Auditing or consulting experience
Project coordination or project management experience
Experience with filings in SERFF
Report and presentation development experience
Ability to effectively interact with reviewer-level state/federal regulators
Additional Information
For 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 a healthcare company 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 OR
Commit to weekly testing, following all CDC protocols, OR
Provide 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 Hours
40

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