Insurance Compliance Analyst (Contract Compliance Advisor or Sr) - 19517

WellPoint is the nation's leading health benefits company serving the needs of approximately 28 million medical members nationwide.



Ensures business unit/ legal entity compliance with legislative and regulatory requirements for assigned lines or business and states of operation. Maintains working knowledge of laws and regulations regarding medical plans which affect assigned states. Manages compliance process by working with associates to comply with requirements. Monitors compliance system for areas of non-compliance. Monitors internal associate corrective action implementation. Researches regulatory changes and creates compliance tools and policies and procedures for compliance. Facilitates implementation of audit and regulatory recommendations and requirements. As needed, prepares documents and tracks compliance information and/or regulatory filings. Assesses and evaluates progress towards meeting standards. Compiles documentation for presentation to regulatory organizations. Performs other related duties as required.



Requires college graduate and 5 years experience in a health care setting, including 3 years experience with insurance filings and regulations,  3 years of compliance experience in a managed care setting, or equivalent combination of education and experience.  Must demonstrate ability to work on complex compliance issues with minimal supervision. Experience in researching applicable state insurance laws and federal insurance laws andcompliance matters and/or drafting language for health insurance policies and certificates for small employer group plans and/ or individuals is preferred.  Also, negotiation experience with state Insurance Departments or other regulatory agencies would be useful.  Top written and oral communication skills are essential as well as ability to work both  independently and as part of a collaborative team. Experience as a paralegal with comparable research and drafting experience will be considered .