Compliance Manager Group Benefits

Overview

Manages the compliance program for Group Benefits business (e.g., stop loss, limited medical, group accident insurance coverage). Develops and implements compliance policies and procedures for Group Benefits. Works with internal and external partners on compliance and related matters. Develops and files policy forms in all states and the Interstate Insurance Compact for approval, as required. Manages regulatory reporting and oversees the Group Benefits business compliance with HIPAA and other privacy and data security laws. Serves as an insurance regulatory subject matter expert and provides compliance guidance to business unit management and helps to resolve any areas of noncompliance in a professional and effective way. Works with minimal supervision, escalating when necessary, and updating management on a regular basis.

Responsibilities

What you will do:

• 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 Gerber Life on enterprise projects and initiatives, as needed. Performs other duties as assigned.
• Performs other duties as assigned
• Complies with all policies and standards

Qualifications

• Bachelor's Degree (Required)
• Advanced degree (Preferred)
• 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)
• Working knowledge of group health insurance laws, regulations and best practices and/or substantially related experience. (Required)
• Minimum of 5-7 years of insurance compliance experience. (Required)
• Excellent with Microsoft Office, especially Word, Excel, and PowerPoint.
• 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.
• 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.

Work Setting/Position Demands:

• Works in an office setting and remains in a stationary position for long periods of time while working at a desk, on a computer or with other standard office equipment, or while in meetings. Requires visual acuity to read a variety of correspondence, reports and forms and to prepare and analyze data in an accurate, neat and thorough way. Continuously makes repetitive motions of the wrists, hands and/or fingers. Requires complex reading and writing skills. Hearing and listening ability. Requires standing and walking within the department and throughout the building complex. Sitting, walking, repetitive motions of hands and fingers. Extended hours required during peak workloads or special projects

Travel Requirements:

• None