Regulatory Compliance

Owings Mills, MD
Jun 16, 2017
Jun 21, 2017
Accountant, IT
Full Time
Summary: The Regulatory Compliance Paralegal supports the VP, Compliance to ensure Avesis' business practices comport with all applicable laws, regulations, and corporate standards. Combining your legal background with an understanding of corporate business objectives, you will be asked to craft and monitor procedures that assist the company meet its financial goals while simultaneously ensuring that all operations align with established best practices.Essential Job Functions and Responsibilities:Maintain a proficient knowledge of state insurance rules, and other applicable rules and regulations and their impact on the line of business, including compliance with rules and regulations which may impact the business group.Responsible for preparing and filing insurance entity and corporation licensing and renewals; interaction with state and federal agency personnel.Draft and monitor the updating of business unit policies and procedures in compliance with client contracts, UR and TPA license requirements, federal and state law and NCQA and URAC accreditation standards.Actively participate in projects/initiatives which promote efficiencies and/or stronger control environments in the line of business.Responsible for conducting independent research to ensure compliance with regulatory requirements and assessing risk to the organization, while monitoring for patterns and trends to identify potential compliance or regulatory issues.Responsible for identification and recommendations related to creation of additional oversight metrics, controls and reporting.Responsible for assessing and reporting on the quality of compliance by line of business in conjunction with the Compliance Program.Assist in developing recommendations to line of business related to products, services, policies and procedures to ensure compliance with regulatory requirements and best practices.Assist in researching matters as necessary to determine scope and impact to the line of business in evaluating compliance with regulatory requirements and adequate controls.Job Requirements:Proficiency in Microsoft Office Suite requiredExcellent written and verbal communication skillsDetail orientedAble to work independentlyCompliance monitoring and/or audit skillsQualification Requirements:Bachelor's Degree.High degree of knowledge with respect to insurance rules.Solid working knowledge of insurance practices, regulatory guidance and principles.Ability to work under pressure and attention to detail is essential.Some travel may be required.Preferences:Dental or vision benefit plan experience.Seven (7) years of registered insurance compliance or business unit supervisory experience.Knowledge, Skills and Abilities:Experience communicating and interacting with line of business partners and management.Ability to work independently and to analyze and evaluate data and facts.Experience in compliance testing and oversight or auditing.Proficiency in Microsoft Excel, Word, Access and PowerPoint.

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