Insurance Regulatory Analyst I

AgencyDept of InsuranceDivisionCompany Services GroupJob Classification TitleInsurance Regulatory Analyst I (NS)Position Number60013616GradeNC17About UsThe mission of the North Carolina Department of Insurance is to promote a stable insurance market through unbiased regulation and to protect the lives and property of every citizen in all 100 counties while fostering superior, user-friendly service, courtesy, and respect. Our agency licenses insurance agents, adjusters, bail bondsmen and more, along with investigating fraud matters involving insurance consumers and any entity or individual regulated by the Department. In an ever-changing environment, it is the vision of the Department of Insurance to maintain the stabilization of the insurance industry in order to provide more products, competitive prices and consumer protection.Description of WorkInsurance Regulatory Analyst I - 60013616Salary Recruitment Range: $60,881-$65,000Salary Grade: NC17The posting will close at 11:59 p.m. the night before the closing dateThis position currently qualifies for a hybrid telework option with routine office and up to one remote workday per week. The NC Department of Insurance trusts our employees to be self-motivated and successful in hybrid/remote roles. Telework options are subject to change at the discretion of management.The Health Market Analyst supports Market Regulation by collecting, reviewing, and analyzing data from all licensed domestic and foreign insurance entities operating in North Carolina. The primary purpose of this role is to identify early market disruptions and help prevent consumer harm by evaluating compliance with state insurance laws, regulations, bulletins, and related requirements. The analyst conducts detailed analytical studies using various software tools, assists examination teams by procuring and analyzing data, participates in technical projects, and prepares reports sourced from multiple information systems.Key Responsibilities• Conduct Level 1 and Level 2 market analyses using the NAIC Market Analysis Review system.• Review Market Conduct Annual Statement filings for Health and Other Health insurance products.• Analyze trends in complaints, underwriting, claims handling, utilization management, grievances and appeals, provider access, and network adequacy.• Assess financial and operational information to determine whether additional regulatory review or a market conduct examination is warranted.• Monitor insurer compliance with North Carolina insurance laws and managed care regulations.• Prepare clear, well‑supported market analysis reports and recommend regulatory actions when appropriate.• Collaborate with Market Conduct Examiners to identify insurers that may require further examination.• Evaluate health insurance data to identify patterns related to claim denials, rescissions, cancellations, prior authorizations, and consumer complaints.• Maintain thorough, organized documentation to support regulatory findings, recommendations, and decisions.Knowledge Skills and Abilities/Management Preferences• Proficiency in Excel.• Experience in auditing, analysis, or other detail oriented work.• Relevant industry designations (such as HIA, ALHC, MHP, RHU, MCM).• Experience using NAIC information systems.• Background in data mining and data analysis.• Experience working with regulatory or compliance issues.• Advanced understanding of health insurance operations, concepts, and applicable state statutes and regulations.• Ability to interpret and apply laws and regulations, analyze complex information, and assess the impact of company policies and procedures.• Strong verbal and written communication skills, with the ability to interact effectively with management, peers, and industry representatives.Minimum Education and ExperienceSome state job postings say you can qualify by an “equivalent combination of education and experience.” If that language appears below, then you may qualify through EITHER years of education OR years of directly related experience, OR a combination of both. See the Education and Experience Equivalency Guide for details.Bachelor's degree in business or economics or a related program from an appropriately accredited institution and three years of experience in policy and rate examinations, underwriting, claims adjusting work, or financial/marketing analysis; or an equivalent combination of training and experience.Benefits of NC State Employment:We value our employees and offer a wide variety of competitive and family-friendly benefits. Benefits include:12 Annual paid HolidaysNorth Carolina State Health Plan administered by AETNASupplemental Benefits including: Flexible Spending Accounts, Accident Insurance, Cancer & Specified Disease, Critical Illness, Dental and VisionNC State Retirement (TSERS)WeSave Employee DiscountsLearn more about employee perks/benefits:Why Work For NC?NC OSHR: BenefitsSupplemental and Contact Information:For consideration for this vacancy, all applicants must complete an online application using the “APPLY” button above.To receive credit for your work history and credentials, you must list the information on the State Application. Any information omitted from your application cannot be considered for qualifying credit.***Applications with "see attached" or resumes in lieu of completed education and work experience on the formal application will be deemed incomplete and will not be eligible for consideration for the vacancy***Applications for positions requiring specific coursework must be accompanied by a copy of the applicant's transcript.The Department of Insurance/Industrial Commission may conduct criminal history checks of all job applicants recommended for employment. Failure to accurately acknowledge information on criminal convictions on the state application form will be grounds for non-consideration of applications, disciplinary action, and possible criminal prosecution.The Department of Insurance/Industrial Commission is an Equal Employment Opportunity employer and uses the merit-based recruitment and selection plan to fill positions subject to the State Personnel Act with the most qualified individuals.Academic Degrees must be from appropriately accredited institutions and will be verified. If you are selected for a position at DOI/IC, your academic credentials will be verified.Applicants requesting and receiving an accommodation under the Americans with Disabilities Act (ADA) are eligible to submit paper applications via mail or by fax.Applicants seeking Veteran's Preference under N.C.G.S .126 must submit a DD Form 214, Certificate of Release or Discharge from Active Duty. This information may be attached to the online application or be faxed on or before the closing date.Applicants may check the status of their application for a vacancy at any time by logging in to the government jobs system. Once the applicant has logged in, the status of each submitted application is documented next to each vacancy for which they have applied.For more information about NCDOI: StatementT he State of North Carolina is an Equal Employment Opportunity Employer and dedicated to providing employees with a work environment free from all forms of unlawful employment discrimination, harassment, or retaliation. The state provides reasonable accommodation to employees and applicants with disabilities; known limitations related to pregnancy, childbirth, or related medical conditions; and for religious beliefs, observances, and practices.Recruiter:Gretchen Marie SenezRecruiter Email:View email address on click.appcast.io #J-18808-Ljbffr State of North Carolina - Insurance