Emergent Holdings · 10 hours ago
Compliance & Quality Specialist, REMOTE
United States
Full-time
Remote
Senior Level
$70K/yr - $118K/yr
5+ years exp
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Responsibilities
Perform audits as assigned including but not limited to quality assessments which may require calibration, risk assessments, reserve oversight, compliance focused state specific audits, and compliance audits of core functions with high regulatory oversight.
Draft audit reports, maintain audit schedules, and collaborate with stakeholders to develop plans of action and ensure execution and completion of action items.
Enterprise technical expert responsible for researching, monitoring and making recommendations including but not limited to state and federal rules and regulations, industry & the Company benchmarks, complex case management, reserving and the Company standards and practices.
Lead and coordinate components of external state and federal audit requests.
Drive execution and resolution of identified compliance issues including but not limited to developing and directing plans for response to state and federal rules and regulations that impact the Company.
Build, audit and report on self-monitoring activities including but not limited to the effectiveness of the Company compliance with state and federal rules, adherence to our S&P around handling of insurance department consumer complaints, penalty resolutions and authorities, and compliance with state reporting bureau data.
Audit enterprise standards and practices for handling of state and other audits.
On behalf of the enterprise, manage vendor relationships related to regulatory reporting, auditing and compliance activities.
Central point of contact on compliance issues for the OGC, OGACC, Finance, Actuarial, and Governmental Relations.
Lead activities on new state entry process to ensure compliance with state requirements.
Build and maintain a compliance library and an historical tracking of regulatory activity and claim handling changes that includes a description, impact to the Company statement, and action taken to track and report on all activity.
Monitor and report on regulatory updates from OGC and Regulatory Services; Ensures appropriate action is taken.
Identify training needs based upon audit findings and state/federal regulatory rules and changes. Serve as a subject matter expert in support of compliance and related training initiatives.
Represents the department and corporation on various committees and events as appropriate.
Performs special projects, as assigned.
Maintains confidentiality of all information processed.
Serve as a mentor and resource to other staff.
Qualification
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Required
Bachelor’s degree in insurance, business or a related field.
Five years in Property and Casualty or compliance environment required.
Demonstrated technical knowledge in three or more of the following areas: compliance research and oversight, case management, case reserving, auditing, vendor management, NCCI or similar knowledge that provides the necessary skills, knowledge and abilities.
Continuous learning, as defined by the Company’s learning philosophy, is required.
Extensive knowledge of Property and Casualty lines of insurance with specific knowledge in one or more of the following areas: state and federal compliance rules and regulations, Medicare compliance, industry and the Company benchmarks.
Ability to exercise sound, consistent judgment in evaluating and recommending compliance and handling action.
Ability to read, interpret and understand contract language.
Knowledge of ability to analyze and interpret law, federal and state rules and regulations, jurisdiction and compliance.
Excellent oral and written communication skills.
Excellent analytical skills to identify improvement opportunities, develop solutions and assess impact.
Ability to interact with all levels of internal staff and management, and effectively exchange information clearly and concisely, present ideas, report facts and other information, as well as respond to questions as appropriate.
Strong interpersonal skills with well-developed conflict management/negotiation and presentation skills.
Ability to manage multiple projects and meet necessary deadlines with minimal direction.
Ability to perform necessary mathematical computations.
Ability and proficiency in the use of computers and company standard software specific to position.
Ability to maintain confidentiality.
Ability to perform other assignments at locations outside the office.
Preferred
Multi-state experience or compliance auditing preferred.
Progress towards or completion of, industry-recognized professional designations preferred.
Certification or progress toward certification is highly preferred and encouraged.
Company
Emergent Holdings
Emergent Holdings’ elite team makes lives, companies and communities better! Emergent Holdings is driven by a singular goal — improving the health and safety of our customers and our communities.
1,001-5,000 employees
Funding
Current Stage
Late StageLeadership Team
John S. Roberts
Executive Vice President, Emerging Markets & Chief Administrative Officer
Brittanie Benson
Human Resources Business Partner
Company data provided by crunchbase
