Senior Compliance Specialist - Remote
Company: CONNECTI CARE, Inc
Location: Farmington
Posted on: March 10, 2023
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Job Description:
Connecticare is a leading health plan in the state of
Connecticut and a subsidiary of EmblemHealth, a health and wellness
company that provides insurance plans, primary and specialty care,
and wellness solutions. WellSpark is a digital wellness company and
national subsidiary of EmblemHealth that offers a full suite of
products and solutions to reward people for healthy behaviors.To
protect the health and safety of our workforce, members, patients,
and the communities we serve, the EmblemHealth family of companies
require all new employees to be fully vaccinated for COVID-19.
Exemption/reasonable accommodations may be granted because of 1) a
qualifying medical condition or disability that makes getting the
vaccine unsafe for the individual, or 2) objection on the basis of
sincerely held religious beliefs and/or practices.
---- Provide support in executing daily operations that maintain
the ConnectiCare Commercial Regulatory Compliance Program.
--- Work with the Director and Manager of Compliance to ensure that
the commercial lines of business are in compliance with all
applicable federal, state, and local regulations.
--- Monitor compliance; provide recommendations and feedback
regarding potential issues and remediations.
--- Perform and/or assist in the performance of regulatory audit
activities including preparation activities and follow-up.Principal
Accountabilities--- Conduct compliance reviews related to the
commercial lines of business.
--- Conduct regulatory compliance monitoring activities for the
commercial lines of business (monitor compliance SLA
results and KPIs; CAP implementation; conduct post-implementation
audits, etc.).
--- Work with business areas to ensure appropriate corrective
actions are taken; maintain documentation, including
investigatory notes and regulatory notifications.
--- Provide regulatory guidance and oversight to business areas
related to state and federal regulatory requirements.
--- Assist with preparation for and coordination of external
regulatory audits: market conduct exams, targeted market
conduct exams, and market conduct annual statement (MCAS)
filings.
--- Coordinate responses to regulatory reports and requests.
--- Conduct other compliance activities and projects as assigned or
required.Education, Training, Licenses, Certifications---
Bachelor's degree required, preferably in health care or
business-related field.Relevant Work Experience, Knowledge, Skills,
and Abilities--- 4 - 6+ years of experience in health insurance
operations and/or compliance. (R)
--- Audit experience a plus. (P)
--- Ability to interpret laws and regulations. (R)
--- Strong communication skills (verbal, written, presentation,
interpersonal) with all types/levels of audience. (R)
--- Demonstrated ability to successfully manage several complex
projects simultaneously. (R)
--- Ability to work independently and as part of a team. (R)
--- Ability to work with internal personnel at all levels and in
all areas of the Organization to achieve success. (R)
--- Strong organizational, analytical, project management and
problem-solving skills. (R)
--- Proficient in use of Microsoft Office (Word, Excel and
PowerPoint; Access is a plus). (R) Additional Information
Keywords: CONNECTI CARE, Inc, Farmington , Senior Compliance Specialist - Remote, Other , Farmington, New Mexico
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