Note: The job is a remote job and is open to candidates in USA. Examination Resources, LLC (ER) is a woman-owned small business that provides expertise in insurance company operations for regulators. They are seeking a Senior Regulatory Compliance Analyst to conduct audits of Life and Health Insurance Companies regarding compliance with the Mental Health Parity and Addiction Equity Act (MHPAEA). This role involves analyzing documentation, summarizing compliance issues, and recommending corrective actions.
Responsibilities
- Independently complete reviews (audits) of company documentation for compliance with the requirements of the Mental Health Parity and Addiction Equity Act
- Analyzing company documentation for compliance with federal legislation
- Documenting and summarizing results of analysis to demonstrate evidence of compliance issues and conclusions reached
- Develop recommendations for corrective actions to remediate instances of non-compliance
- Draft requests for information (RFI) and compliance communications to audit stakeholders in order to clearly convey audit results and ensure corrective actions are taken to obtain compliance
Skills
- Independently complete reviews (audits) of company documentation for compliance with the requirements of the Mental Health Parity and Addiction Equity Act
- Analyzing company documentation for compliance with federal legislation
- Documenting and summarizing results of analysis to demonstrate evidence of compliance issues and conclusions reached
- Develop recommendations for corrective actions to remediate instances of non-compliance
- Draft requests for information (RFI) and compliance communications to audit stakeholders in order to clearly convey audit results and ensure corrective actions are taken to obtain compliance
- Ability to adapt to frequently changing priorities
- Strong problem-solving and critical thinking skills
- Proficient in Microsoft Office (Word, Excel, PowerPoint, and Outlook) and Adobe Acrobat PDF
- College degree or equivalent experience required
- 3+ years of health insurance regulatory and compliance experience, preferably audit experience
- Ability to manage multiple projects while meeting internal and external deadlines
- Exceptional written and oral communication skills
- Insurance industry designations such as Market Conduct Management (MCM), Accredited Insurance Examiner (AIE), and/or Certified Insurance Examiner (CIE)
- An understanding of how the MHPAEA requirements apply to health insurance policies, financial requirements, non-quantitative treatment limitations, fail first requirements, levels of care, step therapy, network adequacy, utilization review, medical necessity review criteria, and how formularies are set
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