State Compliance Analyst II (Remote)

Regulatory & ComplianceRemote, United States


Description

American Specialty Health Incorporated is seeking a State Compliance Analyst II to join our Regulatory and Program Compliance department. This position will support the company’s national regulatory compliance efforts. Note: The individual in this position is not intended to practice law or provide legal advice.

Remote Worker Considerations:
Candidates who are selected for this position will be trained remotely and must be able to work from home in a designated work area with company-provided technology equipment. This remote/WFH position requires you have a stable connection to your Internet Service Provider with the ability to participate by video in online meetings over a reliable and consistent network (minimum internet download of 50 Mbps and 10 Mbps upload speed).  

Salary Range

American Specialty Health complies with state and federal wage and hour laws and compensation depends upon candidate’s qualifications, education, skill set, years of experience, and internal equity. $48,000 to $62,000 annual Salary.

Responsibilities

  • Supports Regulatory and Program Compliance Department activities by focusing on the following key accountabilities in relation to 8-12 assigned states.
  • Maintains required business licenses in a constantly changing regulatory environment. Demonstrates strong understanding of the business need for each license and the consistent ability to independently interpret the laws regarding licensing requirements for each license in assigned states. Appropriately escalates concerns and potential risks to supervisor but demonstrates ability to present solutions and take steps to address such concerns proactively and appropriately.
  • Communicates and coordinates externally with regulatory authorities to understand enforcement expectations. Demonstrates the ability to successfully negotiate with such authorities to achieve interpretations of regulatory requirements, consulting with supervisor on an ad-hoc basis regarding outcome of communication. Effectively educates external contacts regarding unique aspects of ASH’s business practices with limited need for involvement from management. Appropriately escalates concerns and potential risks to supervisor but demonstrates ability to present solutions and take steps to address such concerns proactively and appropriately.
  • Communicates and coordinates internally with various departments to understand detailed rationale of operations and to communicate detailed aspects of regulatory enforcement expectations of such operations. Such communications to demonstrate recommended courses of action that reflect detailed interpretation and translation of enforcement expectations based on detailed understanding of current business practices. Also effectively communicates with internal departments to obtain and evaluate 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. Appropriately escalates concerns and potential risks to supervisor but demonstrates ability to present solutions and take steps to address such concerns proactively and appropriately.
  • Demonstrates subject matter expertise on regulatory enforcement expectations in assigned areas across topics despite a constantly evolving regulatory environment
  • 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 and efficiently monitors legislative and regulatory activity impacting company operations in assigned areas. 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 oral presentations to designated committees and senior management. 
  • Performs detailed research, analysis and summarization of regulatory compliance issues reflecting a strong understanding of regulatory requirements and business operations and objectives. Recommends courses of actions regarding regulatory compliance issues and presents recommendations to internal stakeholders. Resolves ad-hoc compliance issues. Appropriately escalates concerns and potential risks to supervisor but demonstrates ability to present solutions and take steps to address such concerns proactively and appropriately.
  • 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.
  • Supports department with regulatory compliance projects that impact regional and national service areas.
  • Supports regulatory compliance efforts for the company by focusing on the following:
  • 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.
  • Assumption of responsibility for additional states/areas as directed by management either on a transitional basis or as needed.
  • 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.
  • As directed by management, assists with training for other department staff and development of department procedures and protocols.
  • Supports the company’s overall activities by focusing on the following:
  • 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.
  • Completes all ASH University training requirements, including required regulatory trainings, as well as ad hoc trainings required by management, within required timeframes.

Qualifications

  • Bachelor’s degree in Health Care Policy or Administration, Law, Political Science, English or equivalent degree required; Master’s degree in Health Care Administration or Policy, or equivalent degree or experience preferred.
  • Minimum 3-4 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.

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

Work-from-home (WFH) environment

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.
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