Insurance Compliance Manager, Group Benefits

Our client, a leading insurance company, located in White Plains, NY, seeks a Compliance Manager, Group Benefits, to manage the compliance program for Group Benefits business (e.g., stop loss, limited medical, group accident insurance coverage). This role is on-site Monday - Friday. Salary is $110,000-$140,000. Duties and Responsibilities: Maintains the Group Benefits business compliance program, including providing guidance to internal and external partners, as a subject matter expert.Performs legal research and tracks regulatory developments to update compliance policies and procedures.Oversees the Group Benefits business compliance with HIPAA and other privacy and data security laws in collaboration with team members.Assists with audits of third-party business partners and oversees any necessary remediation.Assists with compliance change management efforts, ensuring that requirements are identified and addressed in a timely manner. Participates on the Company Compliance Action Team to help implement compliance requirements.Drafts and maintains Standard Operating Procedures (SOPs), product manuals and other written guidance for internal and external partners.Develops and rolls out compliance training, and ensures internal and external partners receive appropriate guidance on compliance policies and procedures.Manages the resolution of regulatory inquiries and reviews (including complaints, market conduct exams, and surveys). Ensures all regulatory responses are timely, accurate and high quality.Works with internal and external partners to collect and analyze data, and timely report to regulatory agencies, including maintaining a tracking calendar for such regulatory reports.Oversees the drafting of life and health policies, ensuring compliance with applicable laws (e.g., group accident, student accident, vision, dental, medical stop loss and other health insurance coverages). Collaborates with internal and external partners involved with developing and filing policies for existing and new products. Files and negotiates insurance policy approvals with the Interstate Compact and state insurance departments.Records, investigates and escalates alleged non-compliance with laws, regulations, and company policies for appropriate handling.Represents company on enterprise projects and initiatives, as needed. Complies with all policies and standardsRequirements: Bachelor's Degree (Required)Advanced degree (Preferred)Minimum of 5-7 years of insurance compliance experience. (Required)Working knowledge of group health insurance laws, regulations and best practices and/or substantially related experience. (Required)Proven examples of experience leading projects and the ability to manage multiple priorities simultaneously. (Required)Demonstrated experience identifying, defining and resolving problems, and collecting and interpreting data to establish facts, draw valid conclusions and provide effective resolutions. (Required)Demonstrated experience working as part of a team developing cooperation and collaborative work efforts toward solutions that benefit all parties involved. (Required)Demonstrated effective verbal and written communication skills with the ability to convey information to internal and external customers in a clear, accurate, focused and concise manner.Demonstrated ability to document procedures and activities in a manner that is understandable to others and prepared using a prescribed format.Verbal and written communications are to conform to proper rules of punctuation, grammar, diction and style.Demonstrated high level of attention to detail and excellent organizational skills.Proven research, problem-solving and analytical skills, including experience using various websites and reference manuals/tools.Proven ability to take decisive action.Computer Skills and Knowledge of Hardware & Software RequiredExcellent with Microsoft Office, especially Word, Excel, and PowerPoint.Ability to learn and use electronic compliance programs (e.g., RegEd (Code) and Serengeti).Knowledge of legal research engines (e.g., Westlaw).Proficient using SERFF.

Created: 2024-11-07