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Years of Experience
Date Last Verified
ProfileCompliance Analyst The candidate will respond to external requests for information required by the organization for its regulatory filings.Will respond to inquiries from state and federal regulatory agencies. Monitor pending legislation and regulations affecting firm Health Insurance Marketplace products. Maintain database and other reference materials related to legislative and regulatory issues and compliance. Communicate state and federal requirements to internal and external clients. Provide development guidance and assists in the identification, implementation, and maintenance of compliance policies, procedures and work instructions. Assist in the identification, analysis, and resolution of compliance issues. Maintain and reviews regulatory documentation necessary to maintain corporate standards. Assist in developing, producing and conducting compliance training programs. Perform periodic compliance audits, risk assessments and conducts related ongoing compliance monitoring activities. Assist health plans in managing relationships with regulatory agencies and seek to resolve policy issues which may negatively impact service to members. Plan, direct and coordinate the implementation of Compliance Committee policy to ensure decisions are properly executed. Serve as a company wide resource and liaison on policies, contract issues and provisions, communications, workflow, and quality improvements initiatives. Bachelor’s degree in related field or equivalent experience is needed. Master's or JD degree preferred and may be considered in lieu of experience. Should have 1+ year of related experience in compliance, privacy and/or regulatory affairs. Working knowledge of laws and/or regulations in area of compliance; in particular HIPAA, and state regulations. Experience with the Health Insurance Marketplace or Commercial products is preferred.