Health Insurance Examiner

1 week ago


Tampa, Florida, United States StrategyGen Co Full time
Job Summary

We are seeking an experienced Health Insurance Examiner to join our team at StrategyGen Co. As a key member of our team, you will be responsible for evaluating health insurance issuers' compliance with state and federal laws and regulations.

Responsibilities
  • Collaborate with senior examiners to develop and execute market conduct activities, providing regular updates and escalating risks and issues as needed.
  • Assist in preparing requests for information to issuers and preparing work plans for market conduct examinations.
  • Collect and analyze issuers' records, files, and data to evaluate compliance with state and federal laws and regulations.
  • Document findings, prepare workpapers, and submit deliverables for supervisory review.
  • Assist in preparing draft reports, exhibits, and supporting documentation.
  • Perform research and analysis of regulatory updates and guidance issued by CCIIO to issuers.
  • Review and support the update of examination protocols when new regulations are released.
  • Serve as a subject matter expert and resource to other staff.
Requirements
  • Bachelor's degree from an accredited college plus 1-2 years of relevant experience.
  • Significant experience in the health insurance sector, specifically related to healthcare compliance, healthcare regulations, healthcare auditing, or fraud investigation.
  • Must hold the Market Conduct Management (MCM) designation from the Insurance Regulatory Examiners Society.
  • Accredited Insurance Examiner (AIE) designation is a plus.
Skills and Knowledge
  • Extensive knowledge of state and federal laws and regulations pertaining to the Affordable Care Act, Mental Health Parity and Addiction Equity Act, and No Surprises Act.
  • In-depth knowledge of standards and processes in the NAIC's Market Regulation Handbook.
  • Strong project management, organizational, communication, and writing skills.
  • Excellent interpersonal skills, with the ability to build strong working relationships.
  • High-level attention to detail.
  • Intermediate level computer skills, including MS Outlook, Excel, Word, Adobe, and PowerPoint.
About StrategyGen Co

StrategyGen Co is a unique and differentiated HUBZone small business that provides highly specialized policy and regulatory specialists, market researchers, healthcare professionals, physicians, clinicians, and SME PhDs. Our mission is to exceed our clients' expectations by providing innovative, pragmatic, and cost-effective solutions for their most complex problems. Our vision is to improve the health of healthcare for good.



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