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Compliance Analyst - Health Insurance Plans (Hybrid)

$60.28k - $66k

Virginia Jobs

Additional Detail

Compliance Analyst - Health Insurance Plans (Hybrid)

Starting Salary Range: $60,278 - $66,000

The State Corporation Commission's (SCC) Health Benefit Exchange (HBE) division seeks a Compliance Analyst - Health Insurance Plans to join our team. This position supports the certification and compliance of health and dental plans on Virginia's health insurance marketplace. The SCC offers a flexible hybrid work schedule, on-the-job training, and professional development opportunities. More information about Virginia's Insurance Marketplace, a service of the Health Benefit Exchange, may be found at marketplace.virginia.gov.

Essential Duties & Responsibilities

  • Review, analyze, and complete annual certification compliance reviews of Qualified Health Plans (QHPs) and Qualified Dental Plans (QDPs).
  • Review, monitor, analyze state and federal regulations and guidance regarding carrier compliance.
  • Communicate with health and dental carriers regarding carrier certification, compliance findings, operational issues, and recommendations for enhancements.
  • Review and analyze carrier and plan-related data in collaboration with others in the HBE and the SCC's Bureau of Insurance.
  • Coordinate and monitor carrier onboarding, offboarding, reporting, and maintenance of carrier's access and information in the exchange platform.
  • Coordinate with the SCC's Bureau of Insurance on concerns found during compliance reviews and make recommendations accordingly for plan recertification and decertification.
  • Prepare and communicate carrier meeting agendas and meeting minutes.
  • Prepare periodic reports for carriers.
  • Perform related work as required.
Preferred Qualifications
  • 2 or more years of related professional experience in health insurance or compliance and a bachelor's degree.
  • In lieu of a bachelor's degree, approximately 6 years of related experience.
  • Knowledge of insurance terminology, health insurance plans, form and rate filings, and/or Virginia rules and regulations is a plus.
  • Ability to read, analyze and interpret laws, regulations, and guidance.
  • Ability think critically and apply analytical skills.
  • Strong verbal and written communication skills.
  • Exceptional attention to detail.
  • Ability to prioritize and meet deadlines.
  • Ability to multitask and adapt to changing priorities in a dynamic environment.
  • Ability to maintain effective, professional working relationships with SCC staff, industry personnel, and the general public.

Please Note: SCC only accepts applications received through its career center site. Applications submitted through Virginia Jobs site directly will not be considered.
For more information and to apply for this position directly on the SCC Career Center website, click the Additional Detail button on this page.
To view all current SCC job openings, visit the SCC Career Center website and click the Search button under Job Search.

Each agency within the Commonwealth of Virginia is dedicated to recruiting, supporting, and maintaining a competent and diverse work force. Equal Opportunity Employer
Vacancy posted 19 hours ago
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