Senior Insurance Product Compliance Professional

🕒 5 days ago

🇺🇸 United States – Remote

💵 $78.4k - $107.8k / year

⏰ Full Time

🟠 Senior

🚔 Compliance

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Humana

WebsiteLinkedInAll Job Openings

10,000+ employees

Founded 1961

🏥 Healthcare

🛡️ Insurance

⚕️ Healthcare Insurance

Healthcare • Insurance • Healthcare Insurance

Humana is a healthcare company dedicated to making a positive impact on the health of individuals, communities, and the healthcare system as a whole. With a focus on putting health first, Humana serves a diverse range of populations, including seniors and the military, providing Medicare Advantage HMO, PPO, and PFFS plans. Humana is committed to fostering a culture of belonging and mutual respect, offering competitive and flexible benefits to ensure the financial security of its employees and their families. The company prides itself on creating an inclusive workplace where everyone has the opportunity to succeed.

📋 Description

• 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 determine how to handle technical work for complex project components • Develop and maintain group policy and certificate language to support product initiatives, administrative practices, and applicable regulatory requirements • Create awareness of current regulatory issues and ensure policy and certificate forms for the company's life, ancillary, and supplemental health insurance products remain compliant • Monitor and analyze regulatory requirements to assess insurance contract language impacts • Develop and maintain self-funded group contract templates for assigned product(s) • Facilitate discussions with operational and compliance partners • Prepare standard policy and certificate forms for use as templates for regulatory filings • Research and develop written responses for regulatory objections, exams, and inquiries • Maintain accurate and thorough documentation • Conduct quality reviews to ensure accuracy and compliance of assigned materials • Recommend and support process improvements to maximize efficiency • Research and provide timely impact responses to Request for Proposals (RFPs) and/or Pre-sale Quotes (PSQs) • Serve as Subject Matter Expert (SME) for assigned product lines • Conduct and/or assist with research 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, 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 • many other opportunities