State Compliance Analyst I

American Specialty Health, Inc. is seeking a state compliance analyst to support the company’s national regulatory compliance efforts. The ideal candidate will have strong analytical and writing skills, outstanding research abilities, and excellent communication. The analyst will act as the subject matter expert on regulatory enforcement expectations in assigned states in a constantly evolving environment. Note: The individual in this position is not intended to practice law or provide legal advice.

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Responsibilities

  • Maintains required business licenses in a constantly changing regulatory environment.  Develops understanding of the business need for each license and interprets the laws regarding licensing requirements for each license in assigned states. Consults with supervisor on an as needed basis to resolve any issues and to mitigate associated risks.
  • Communicates and coordinates externally with regulatory authorities to understand enforcement expectations including, but not limited to, successfully negotiating with such authorities to achieve interpretations of regulatory requirements, consulting with supervisor on an ad-hoc basis regarding outcome of communication.  Educates external contacts regarding unique aspects of ASH’s business practices.  Consults with supervisor on an as needed basis to resolve any issues and to mitigate associated risks.
  • Communicates and coordinates internally with various departments to understand rationale of operations and to communicate regulatory enforcement expectations of such operations including recommending courses of action, interpreting and translating enforcement expectations to current business practices.  Also effectively communicates with internal departments to obtain necessary information for regulatory filings based on the needs of each regulatory agency, in part by educating internal contacts on the unique regulatory environments in assigned states.  Consults with supervisor on an as needed basis to resolve any issues and to mitigate associated risks.
  • Researches, communicates and coordinates regulatory compliance issues across multiple disciplines and levels of workforce (i.e. communicates well with staff ranging from entry level to senior executive level personnel).
  • Effectively monitors legislative and regulatory activity impacting company operations in assigned states.  Completes detailed legislative and regulatory reports for assigned states that includes assessments of impact to business operations, consulting with supervisor on an ad-hoc basis to resolve any high level or complex regulatory compliance issues.  Effectively communicates such regulatory changes to organization through written communication and verbal presentations to designated committees and senior management.
  • Performs detailed research, analysis and summarization of regulatory compliance issues.  Recommends courses of actions regarding regulatory compliance issues and presents recommendations to internal stakeholders.  Resolves ad-hoc compliance issues.  Consults with supervisor on an as needed basis to resolve complex regulatory compliance issues.
  • Supports and compiles documents for regulatory filings based on knowledge of unique regulatory framework while meeting required deadlines; such filings include, but are not limited to, the following: license applications, license renewals, financial filings, inquiry/complaint responses and regulatory market surveys for annual and quarterly reports.
  • Project management, and acquiring subject matter expertise, of specific compliance areas impacting assigned states and business operations specific to those states as directed by management.
  • Assists with training of new employees and other department staff as needed on a project basis at the direction of management.
  • As directed by management, assists with completion of multi-state, national or product implementation research projects.
  • Immediately informs supervisor of urgent issues.
  • Provides supervisor with timely periodic assignments status updates.
  • Represents the company in an ethical, professional, and positive manner and complies with all company policies and procedures.
  • Maintains confidentiality of all company information and uses discretion in discussing regulatory compliance issues with internal and external contacts.
  • Maintains computer and system skills necessary to perform job functions.
  • Photocopies, files, scans and faxes as needed to support job responsibilities.
  • Strictly adheres to department administrative guidelines including, but not limited to, guidelines regarding project tracking and record keeping practices.

Qualifications

  • Bachelor’s degree in English, History, Political Science or equivalent; Master’s degree in Health Care Administration, Legal degree or equivalent preferred.
  • Minimum 2 years’ regulatory compliance experience, preferably in a health insurance environment.  Experience to include analyzing and monitoring legislative and regulatory requirements, maintaining regulatory licenses and related filings, communicating with regulatory agencies, and with conducting regulatory compliance research.
  • Experience with health insurance contracts and certificate forms and working with health plans and employer groups helpful.
  • Understanding of Department of Insurance, Department of Health Insurance Law, and/or Health Care Law preferred.
  • Excellent research skills.
  • Strong analytical and writing skills.
  • Understanding of ASH systems, policies and procedures preferred.
  • Proficient in MS Word and ability to work effectively with Excel, Access, Westlaw and other similar research tools.

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Core Competencies

  • Demonstrated ability to interact in a positive, respectful manner and establish and maintain cooperative working relationships.
  • Ability to display excellent customer service to meet the needs and expectations of both internal and external customers.
  • Excellent listening and interpersonal communication skills to identify critical core competencies based on success factors and organizational environment.
  • Ability to effectively organize, prioritize, multi-task and manage time.
  • Demonstrated accuracy and productivity in a changing environment with constant interruptions.
  • Demonstrated ability to analyze information, problems, issues, situations and procedures to develop effective solutions.
  • Ability to exercise strict confidentiality in all matters.

Mobility

Primarily sedentary, able to sit for long periods of time.

Physical Requirements

Ability to speak, see and hear other personnel and/or objects.  Ability to communicate both in verbal and written form. Ability to travel within the facility. Capable of using a telephone and computer keyboard.  Ability to lift up to 10 lbs.

Environmental Conditions

Usual office setting.

American Specialty Health is an Equal Opportunity/Affirmative Action Employer.

All qualified applicants will receive consideration for employment without regard to race, color, religion, sex including sexual orientation and gender identity, national origin, disability, protected Veteran Status, or any other characteristic protected by applicable federal, state, or local law.

Please view Equal Employment Opportunity Posters provided by OFCCP here.

If you are a qualified individual with a disability or a disabled veteran, you have the right to request an accommodation if you are unable or limited in your ability to use or access our career center as a result of your disability. To request an accommodation, contact our Human Resources Department at (800) 848-3555 x6702.

ASH will not discharge or in any other manner discriminate against employees or applicants because they have inquired about, discussed, or disclosed their own pay or the pay of another employee or applicant. However, employees who have access to the compensation information of other employees or applicants as a part of their essential job functions cannot disclose the pay of other employees or applicants to individuals who do not otherwise have access to compensation information, unless the disclosure is (a) in response to a formal complaint or charge, (b) in furtherance of an investigation, proceeding, hearing, or action, including an investigation conducted by the employer, or (c) consistent with the Company’s legal duty to furnish information