[Hiring] Senior Regulatory Compliance Analyst @CareFirst

Role Description

The Senior Regulatory Compliance Analyst will conduct independent analysis for complicated, high level regulatory inquiries and provide interpretation of regulatory rules and guidelines to demonstrate compliance with state and federal requirements. The incumbent will audit internal controls to identify high risk exposure, will provide recommendations to business areas and will track implementation of remedial solutions.

Qualifications

• Bachelor's Degree OR in lieu of a Bachelor's degree, an additional 4 years of relevant work experience is required in addition to the required work experience.
• 5 years experience in a compliance or senior level customer service role.
• Skill in using logic and reasoning to identify the strengths and weaknesses of alternative solutions, conclusions, or approaches to problems.
• Ability to convey information in a clear, concise, and logical manner.
• Ability to effectively convey information to others.
• Excellent critical thinking and communication skills both written and verbal.
• Consistently maintains highly professional written and verbal interaction with all levels of staff within the company and with members of regulatory agencies.
• Must be able to interpret insurance law and regulations.
• Must be able to meet established deadlines and handle multiple customer service demands from internal and external customers, within set expectations for service excellence.
• Must be able to effectively communicate and provide positive customer service to every internal and external customer, including customers who may be demanding or otherwise challenging.

Requirements

• Liaison with Regulatory Agency Investigators (Maryland Insurance Administration {MIA}, Virginia Bureau of Insurance {VBOI} and the District Insurance, Security and Banking {DISB}).
• Frequent interaction with all internal areas especially all Business Units, Legal, Compliance and Legislative Departments.
• Provide interpretation of regulations and regulatory rules/guidelines to demonstrate CareFirst BCBS and its subsidiaries' compliance with state and federal standards.
• Review and analyze all data received in order to generate detailed responses to the originating party.
• Strategizes with Legal and Compliance as needed to identify the best response to the complaint.
• Maintain positive, responsive, respectful relationships with all regulators.
• Research, resolve and respond to written inquiries forwarded from Congressional, Attorney General and State officials, members, providers, groups and brokers.
• Coordinate with internal and external parties to ensure accurate information is obtained.
• Review, analyze, prepare detailed documentation for support of legal action pertaining to CareFirst indemnity business.
• Develop a summary/assessment of included documentation for legal staff.
• Meet, discuss, and strategize with legal staff to prepare for depositions, court cases or administrative hearings.
• Appear as required to testify on behalf of CareFirst.
• Review moderately complex business processes and systems to identify, document, elevate the presence of risks and trends within systems and processes that may be non-compliant with contracts and or statutory requirements.
• Actively participate in implementation/corrective workgroups to ensure compliance perspective and concerns are addressed through the process.
• Provide research, investigative and analytic support on special projects ensuring that all CareFirst policies and contractual guidelines are clearly identified.
• Provide support to supervisors and other internal associates with written responses to inquiries.

Benefits

• Salary Range: $71,496 - $141,999
• Comprehensive benefits package.
• Various incentive programs/plans.
• 401k contribution programs/plans (all benefits/incentives are subject to eligibility requirements).

Company Description

CareFirst BlueCross BlueShield is an Equal Opportunity (EEO) employer. It is the policy of the Company to provide equal employment opportunities to all qualified applicants without regard to race, color, religion, sex, sexual orientation, gender identity, national origin, age, protected veteran or disabled status, or genetic information.