The Benefit Contracts Compliance Manager owns the maintenance of health plan benefit documents including benefit
booklets, Summary of Benefits and Coverage, Summary Plan Descriptions, etc.., ensuring their compliance with state
specific requirements, creating processes for updating and tracking versions of the documents as necessary, and managing
the filing and approval process with the relevant regulatory agencies. This position requires an individual to understand
how a regulation or plan change may affect health plan operational areas.

Full-Time

Job Responsibilities
● Analyze current and new regulations pertaining to group health plans to ensure that member benefit booklets
remain in compliance and are timely filed and approved by regulators.
● Conduct and manage a complete, section-by-section review of plan documents for consistency and regulatory
compliance.
● Develop and maintain benefit document workflows and process improvements, working with the management
team to implement changes.
● Translate complex regulatory requirements into member facing language.
● Act as lead during the plan/product filing process, including managing SERFF submissions and objections.
● Evaluate and interpret benefit language based on applicable laws and internal standards and policies.
● Maintain a document management system to retain historical information on benefit, contract, and regulatory
interpretations to ensure accurate and consistent treatment.
● Actively and effectively collaborate with operational areas, Legal, and Compliance regulatory team members to
ensure benefit language updates are understood and appropriately reviewed. 
● Drafts and maintains relevant policies and procedures and job aides.
● Performs additional responsibilities as needed or assigned.

Qualifications/Skills:

• Bachelor’s Degree with 3-5 years of experience in the health insurance industry required, or equivalent
  combination of education (E.g., J.D. or Masters) and relevant regulatory experience. J.D. helpful but not required.
  Experience with managing Benefit Booklets, Evidence of Coverage, and/or Plan Documents, etc. required.
• Excellent writing skills using proper grammar, punctuation, and sentence structure.
• Knowledge of and experience with ERISA and ACA preferable.
• Familiarity with filing benefit documents with state regulators, particularly via SERFF.
• Self-directed with ability to independently and creatively problem solve. Initiative to raise concerns or suggestions and act as champion for action.
• Ability to analyze, interpret, and convey complex information in a simple and understandable manner.
• Exceptional organizational skills with the ability to prioritize large workloads and competing deadlines.
• Ability to identify and evaluate potential compliance and/or benefit configuration issues and develop recommendations for remediation.
• Strong attention to detail and skill in accurately drafting and editing documents.
• Experience with project and document management.