Talent.com
Senior Insurance Product Compliance Professional-Remote
Senior Insurance Product Compliance Professional-RemoteNorth Carolina Staffing • Raleigh, NC, US
Senior Insurance Product Compliance Professional-Remote

Senior Insurance Product Compliance Professional-Remote

North Carolina Staffing • Raleigh, NC, US
12 hours ago
Job type
  • Full-time
  • Remote
Job description

Senior Insurance Product Compliance Professional

Become a part of our caring community and help us put health first. The Senior Insurance Product Compliance Professional performs consultation and research for policy and certificate language development. Work assignments involve moderately complex to complex issues where the analysis of situations or data requires an in-depth evaluation of variable factors. The Senior Insurance Product Compliance Professional negotiates with state and federal regulatory agencies to obtain approval of insurance policy and certificate forms; supports implementation and maintenance of compliant insurance product policies and certificates; and begins to influence departmental strategy through subject matter expertise. An associate in this role is expected to make independent decisions on moderately complex to complex technical issues regarding project components; operate with minimal direction, and exercise latitude in determining objectives and approaches to assignments.

Responsibilities :

  • Monitor and analyze state / federal regulatory requirements to assess contract language impacts and provide consultative guidance to other associates within the team. Coordinate legislative updates between Group and Individual products where applicable.
  • Collaborate with various teams regarding state / federal requirements that impact existing products, new products, and product refreshes.
  • Create awareness of current regulatory issues and ensure compliance for new and existing policies, certificates, and other related forms.
  • Write generic and / or state-specific group contract language for Specialty policies / certificates to support product initiatives, administrative practices, and regulatory requirements, including applicable readability standards.
  • Facilitate discussions with operational and compliance partners to review and finalize drafted contract language or assist with negotiating regulatory approvals.
  • Research and develop written responses to or provide consultative support for regulatory objections, exams, and inquiries.
  • Maintain accurate and thorough documentation regarding the rationale for new or revised contract language.
  • Conduct quality reviews of generic and state-specific policy / certificate forms.
  • Serve as Subject Matter Expert (SME) for assigned Specialty lines of business and / or topics, triage and answer compliance related questions regarding policy and certificate language.
  • Assist Professional 2s with drafting state forms and understanding state and federal filing requirements.
  • Work with Professional 2s to ensure information on project tracking tools is accurate and current.
  • When needed, support product filings to include drafting, filing, and implementing production forms, including annual On-Exchange product filings / binders.
  • Recommend and support process improvements to maximize efficiency.
  • Draft or provide input to work instructions / process documentation.
  • In conjunction with the Lead(s), provide training and support to new and existing associates as needed.
  • Write and maintain ASO templates (Plan Management Agreement and Summary Plan Description) for assigned group Specialty product(s).
  • Prepare standard policy and certificate forms for use as templates for state and federal regulatory filings and subsequent implementation.
  • Research and provide responses to Request for Proposals (RFPs) and / or Pre-sale Quotes (PSQs).
  • Consult on application filings issues and coordinate filing of applications for group and / or individual Specialty products.
  • Conduct and / or assist with research requests.
  • All other duties as assigned.

Required Qualifications :

  • Bachelor's Degree or equivalent experience in a healthcare / insurance compliance function
  • Minimum 5 years of healthcare / insurance industry experience
  • Knowledge of laws and regulations governing the healthcare / insurance industry experience, such as state Departments of Insurance and CMS
  • Ability to research and analyze state laws and regulations
  • Understanding of insurance products, including policy / certificate language
  • Proficient in Adobe Acrobat and Microsoft 365 (Office) applications, including Word, Excel, Teams, and SharePoint
  • Excellent oral and written communication skills. This includes ability to collaborate effectively with associates across all levels of the organization and reviewer-level state / federal regulators
  • Demonstrated attention to detail and accuracy
  • Proven analytical and problem solving ability
  • Self-Motivated and task oriented, with an ability to manage multiple priorities and work under pressure to meet deadlines
  • Must be passionate about contributing to an organization focused on ensuring compliance and continuously improving consumer experiences
  • Preferred Qualifications :

  • Auditing or consulting experience
  • Project coordination or project management experience
  • Experience with filings in System for Electronic Rate and Form Filing (SERFF)
  • Experience with creating and delivering reports and presentations
  • This role is posted remote nationwide. Regardless of location, it is expected that this person will work East Coast hours.

    Humana values personal identity protection. Please be aware that applicants may be asked to provide their Social Security Number, if it is not already on file. When required, an email will be sent from Humana@myworkday.com with instructions on how to add the information into your official application on Humana's secure website.

    Interview Format : As part of our hiring process for this opportunity, we will be using an interviewing technology called HireVue to enhance our hiring and decision-making ability.

    WAH Internet Statement : To ensure Home or Hybrid Home / Office employees' ability to work effectively, the self-provided internet service of Home or Hybrid Home / Office employees must meet the following criteria : At minimum, a download speed of 25 Mbps and an upload speed of 10 Mbps is recommended; wireless, wired cable or DSL connection is suggested. Satellite, cellular and microwave connection can be used only if approved by leadership.

    Employees who live and work from Home in the state of California, Illinois, Montana, or South Dakota will be provided a bi-weekly payment for their internet expense.

    Humana will provide Home or Hybrid Home / Office employees with telephone equipment appropriate to meet the business requirements for their position / job. Work from a dedicated space lacking ongoing interruptions to protect member PHI / HIPAA information.

    Travel : While this is a remote position, occasional travel to Humana's offices for training or meetings may be required.

    Scheduled Weekly Hours : 40

    Pay Range : The compensation range below reflects a good faith estimate of starting base pay for full time (40 hours per week) employment at the time of posting. The pay range may be higher or lower based on geographic location and individual pay will vary based on demonstrated job related skills, knowledge, experience, education, certifications, etc. $71,100 - $97,800 per year. This job is eligible for a bonus incentive plan. This incentive opportunity is based upon company and / or individual performance.

    Description of Benefits : Humana, Inc. and its affiliated subsidiaries (collectively, "Humana") offers competitive benefits that support whole-person well-being. Associate benefits are designed to encourage personal wellness and smart healthcare decisions for you and your family while also knowing your life extends outside of work. Among our benefits, Humana provides medical, dental and vision benefits, 401(k) retirement savings plan, time off (including paid time off, company and personal holidays, volunteer time off, paid parental and caregiver leave), short-term and long-term disability, life insurance and many other opportunities.

    Application Deadline : 12-07-2025

    About us : Humana Inc. (NYSE : HUM) is committed to putting health first for our teammates, our customers and our company. Through our Humana insurance services and CenterWell healthcare services, we make it easier for the millions of people we serve to achieve their best health delivering the care and service they need, when they need it. These efforts are leading to a better quality of life for people with Medicare, Medicaid, families, individuals, military service personnel, and communities at large.

    Equal Opportunity Employer : It is the policy of Humana not to discriminate against any employee or applicant for employment because of race, color, religion, sex, sexual orientation, gender identity, national origin, age, marital status, genetic information, disability or protected veteran status. It is also the policy of Humana to take affirmative action, in compliance with Section 503 of the Rehabilitation Act and VEVRAA, to employ and to advance in employment individuals with disability or protected veteran status, and to base all employment decisions only on valid job requirements.

    Create a job alert for this search

    Insurance Compliance • Raleigh, NC, US

    Related jobs
    Remote Life Insurance Broker – Flexible Work-Life Balance

    Remote Life Insurance Broker – Flexible Work-Life Balance

    The Edelson Agency • Raleigh, NC, US
    Remote
    Full-time
    Quick Apply
    The Edelson Agency is looking for individuals interested in working remotely as sales representatives.We are looking for business partners, not just sales agents. Performance based income There is N...Show more
    Last updated: 30+ days ago
    Sr. Program Delivery Professional, Claims

    Sr. Program Delivery Professional, Claims

    North Carolina Staffing • Raleigh, NC, US
    Full-time
    Senior Program Delivery Professional.Become a part of our caring community and help us put health first.Join Humana's In Home Well-being Assessment (IHWA) team and take ownership of critical claims...Show more
    Last updated: less than 1 hour ago • Promoted • New!
    Life Insurance Broker (Remote) | Licensed and Unlicensed Welcome

    Life Insurance Broker (Remote) | Licensed and Unlicensed Welcome

    Peterson Life & Wealth • Raleigh, NC, US
    Remote
    Full-time +1
    Quick Apply
    Time freedom, uncapped income, and a team that actually has your back.Join our incredible culture of experienced agents ready to help you take the next step! 🐘 Peterson Life & Wealth is...Show more
    Last updated: 30+ days ago
    Flexible Remote Work – Get Paid to Share Your Opinions on Top Brands

    Flexible Remote Work – Get Paid to Share Your Opinions on Top Brands

    OCPA • Buies Creek, North Carolina, us
    Remote
    Part-time +1
    Product Testers are wanted to work from home nationwide in the US to fulfill upcoming contracts with national and international companies. We guarantee 15-25 hours per week with an hourly pay of bet...Show more
    Last updated: 30+ days ago • Promoted
    Insurance Agent (Base salary + Uncapped commissions)

    Insurance Agent (Base salary + Uncapped commissions)

    Comparion Insurance Agency • Morrisville, North Carolina, United States
    Full-time
    Schedule : Full-Time Salary Range : USD $32000.Job Category : Sales - Comparion The typical starting salary range for this role is determined by a number of factors including skills, experience, educa...Show more
    Last updated: 30+ days ago • Promoted
    Senior Product Leader

    Senior Product Leader

    Grey Search + Strategy • Raleigh, NC, US
    Full-time
    Transform how people connect with and manage their environments through intelligent, connected software solutions.This role leads the strategy, development, and commercial success of a portfolio of...Show more
    Last updated: 14 days ago • Promoted
    NC Insurance Products Agent (Life and / or Health)

    NC Insurance Products Agent (Life and / or Health)

    Team Nexa Insurance Solutions • Raleigh, NC, US
    Full-time
    Quick Apply
    THIS POSITION IS FOR LICENSED AGENTS.THIS IS NOT A REMOTE OFFERRING.OUR AGENTS VISIT THEIR CLIENTS • • Our Agency is currently seeking Life Insurance Agents to work in the State of North Carolina.Tea...Show more
    Last updated: 17 days ago
    Life Insurance Agent

    Life Insurance Agent

    Jessey Agency • Raleigh, NC, US
    Full-time +1
    Quick Apply
    The Jessey Agency, partnered with Symmetry Financial Group, provides a profession that offers the opportunity to control your time, income, and career. With uncapped revenue potential, you can work ...Show more
    Last updated: 30+ days ago
    Life Insurance Sales Agent

    Life Insurance Sales Agent

    SFG - Peterson Agency • Cary, NC, US
    Full-time +1
    Quick Apply
    Companies Hiring The Most High-Paying Jobs In 2024," and listed on INC's "Top 5000 Fastest Growing Companies" for six years in a row, we have a proven system and are hiring hard-working, motivated ...Show more
    Last updated: 30+ days ago
    Senior Account Associate- Commercial Insurance (Remote)

    Senior Account Associate- Commercial Insurance (Remote)

    Insurance Office of America • Cary, NC, US
    Full-time
    Title : Senior Account Associate - Commercial Lines.Please note : If this position is posted as either fully remote and / or hybrid, in accordance with company policy, individuals residing within a 50-...Show more
    Last updated: 30+ days ago
    Insurance Claims Environmental

    Insurance Claims Environmental

    Diedre Moire Corp. • Raleigh, North Carolina, United States
    Full-time
    Complex Claims Analyst Toxic Tort - Raleigh, NC Insurance Claims Specialist Adjuster Examiner Analyst Attorney Environmental Toxic Tort Asbestos Pollution Health Hazard _.REMOTE WORK FROM HOME AVAI...Show more
    Last updated: 3 days ago • Promoted
    Experienced Insurance Agent

    Experienced Insurance Agent

    HealthMarkets • Raleigh, NC, United States
    Full-time
    If you’re looking for an exciting opportunity where you can change people’s lives and achieve financial success as an independent insurance agent, you’ve come to the right place.Becoming an indepen...Show more
    Last updated: 30+ days ago • Promoted
    Senior Product Manager- Data Acceleration

    Senior Product Manager- Data Acceleration

    SAS • Cary, NC, US
    Full-time
    Senior Product Manager For Data Acceleration Hybrid In Cary, North Carolina.Through our software and services, we inspire customers around the world to transform data into intelligence - and quest...Show more
    Last updated: 30+ days ago • Promoted
    Senior Product Manager

    Senior Product Manager

    First Citizens Bank • Raleigh, NC, US
    Full-time
    This is a remote role that may only be hired in North Carolina.This position is aligned to our Direct Bank Digital organization, and leads strategic planning for the accelerated profitability and g...Show more
    Last updated: 30+ days ago • Promoted
    Insurance Benefits Specialist- 100% Remote

    Insurance Benefits Specialist- 100% Remote

    Global Elite • Raleigh, NC, US
    Remote
    Full-time
    Insurance Benefits Specialist- 100% Remote.Now is the best time to join full-time remotely, completely work from home.All benefits representatives start at entry level and move up! Suggested schedu...Show more
    Last updated: 30+ days ago • Promoted
    Senior Account Manager, Full-Service REMS

    Senior Account Manager, Full-Service REMS

    Syneos Health / inVentiv Health Commercial LLC • Morrisville, NC, United States
    Full-time
    A Senior Account Manager is an experienced program / project leader in the Global Risk Management and Full-Service REMS (GRMR) Business. Expectations include the ability to build relationships (intern...Show more
    Last updated: 30+ days ago • Promoted
    Data Protection and Privacy Senior Associate - Business Process Reviews

    Data Protection and Privacy Senior Associate - Business Process Reviews

    EY • Raleigh, NC, United States
    Full-time
    At EY, we're all in to shape your future with confidence.We'll help you succeed in a globally connected powerhouse of diverse teams and take your career wherever you want it to go.Join EY and help ...Show more
    Last updated: 5 days ago • Promoted
    Life Insurance Specialist - North Carolina

    Life Insurance Specialist - North Carolina

    The Auto Club Group • Raleigh, NC, United States
    Full-time
    It's a great time to join AAA The Auto Club Group!.JOIN THE TEAM COMMITTED TO DRIVING YOUR CAREER FORWARD.Payment Terms : $1000 paid after 30 days of employment, $1500 paid after 90 days of employme...Show more
    Last updated: 30+ days ago • Promoted