Group Benefits Compliance Manager
Location: Onsite, White Plains, NY
Salary Range: $110,000-$140,000
Overview
This role involves managing the compliance program for the Group Benefits business, which includes products like stop loss, limited medical, and group accident insurance coverage. The Compliance Manager will develop and implement compliance policies and procedures, work with internal and external partners on compliance matters, and ensure regulatory reporting and adherence to privacy and data security laws such as HIPAA. The role requires serving as a subject matter expert on insurance regulations, providing compliance guidance, and resolving noncompliance issues effectively. The position operates with minimal supervision, escalating issues when necessary and keeping management informed regularly.
Responsibilities
Key Duties:
- Maintain the compliance program for Group Benefits, offering expert guidance to internal and external partners.
- Conduct legal research and monitor regulatory developments to update compliance policies and procedures.
- Ensure compliance with HIPAA and other privacy and data security laws in collaboration with team members.
- Assist with audits of third-party business partners and oversee necessary remediation efforts.
- Support compliance change management, ensuring timely identification and addressing of requirements. Participate in the Company Compliance Action Team to implement compliance requirements.
- Draft and maintain Standard Operating Procedures (SOPs), product manuals, and other written guidance for partners.
- Develop and deliver compliance training, ensuring partners receive appropriate guidance on policies and procedures.
- Manage the resolution of regulatory inquiries and reviews, ensuring timely, accurate, and high-quality responses.
- Collaborate with partners to collect and analyze data, and report to regulatory agencies, maintaining a tracking calendar for such reports.
- Oversee the drafting of life and health policies, ensuring compliance with applicable laws. Collaborate with partners on developing and filing policies for new and existing products, and negotiate insurance policy approvals with the Interstate Compact and state insurance departments.
- Record, investigate, and escalate alleged non-compliance with laws, regulations, and company policies for appropriate handling.
- Represent the company on enterprise projects and initiatives as needed. Perform other duties as assigned.
- Comply with all company policies and standards.
Qualifications
- Bachelor’s Degree (Required)
- Advanced degree (Preferred)
- Proven experience leading projects and managing multiple priorities simultaneously (Required)
- Demonstrated ability to identify, define, and resolve problems, and collect and interpret data to establish facts and provide effective resolutions (Required)
- Experience working as part of a team, fostering cooperation and collaborative efforts toward solutions (Required)
- Working knowledge of group health insurance laws, regulations, and best practices, or substantially related experience (Required)
- Minimum of 5-7 years of insurance compliance experience (Required)
- Proficiency with Microsoft Office, especially Word, Excel, and PowerPoint
- Effective verbal and written communication skills, with the ability to convey information clearly and concisely
- Ability to document procedures and activities in an understandable format
- High level of attention to detail and excellent organizational skills
- Strong research, problem-solving, and analytical skills, including experience using various websites and reference tools
- Ability to take decisive action
- Ability to learn and use electronic compliance programs (e.g., RegEd, Serengeti)
- Knowledge of legal research engines (e.g., Westlaw)
- Proficiency with SERFF
Work Setting/Position Demands:
- Office setting, with long periods of stationary work at a desk or computer. Requires visual acuity for reading and data analysis, repetitive motions of wrists, hands, and fingers, and complex reading and writing skills. Involves standing and walking within the department and building. Extended hours may be required during peak workloads or special projects.
Travel Requirements: