Especialista Senior De Cumplimiento
Regular
Exempt
GENERAL DESCRIPTION:
As Senior Compliance Specialist will be responsible of the analysis, interpretation, and dissemination of communications received from local and federal regulatory agencies to impacted internal and external clients, including First Tier, Downstream, and Related Entities (FDR’s); provide regulatory guidance to internal and external clients; develop and facilitate training and education related to regulatory communications; the review of policies and procedures related to regulatory communications; respond to regulatory inquiries; develop and perform compliance reports, and lead special projects.
ESSENTIAL FUNCTIONS:
- Track and monitor communications and regulations issued by federal and state regulatory agencies. Review, analyze, and interpret new and existing legislation or guidance, ensuring relevant information is shared with impacted internal and external stakeholders.
- Communicate federal and state requirements to internal teams and external clients. Respond to inquiries, ensure compliance, and provide clarity on regulatory expectations.
- Manage compliance-related projects or implementations to address regulatory requirements. Promptly escalate regulatory issues or instances of non-compliance to management for resolution.
- Identify, analyze, and resolve compliance issues in collaboration with internal teams. Develop and recommend effective solutions, advising management on the implications of compliance challenges.
- Partner with internal stakeholders to ensure policies, procedures, and processes comply with federal and state regulatory standards. Provide guidance on regulatory language and assist in the development and maintenance of compliance-related documentation.
- Develop and facilitate compliance training materials to address new regulatory requirements, ensuring stakeholders understand and adhere to updated standards.
- Maintain internal systems and review regulatory documentation to uphold corporate standards. Ensure all records are accurate, complete, and meet regulatory requirements.
- Act as a company-wide resource and liaison, bridging communication between internal teams and external clients regarding regulatory requirements and compliance updates.
- Participated in compliance-related meetings with external clients to discuss regulatory and compliance topics, fostering collaboration and transparency.
- Prepare and deliver compliance reports to management within established deadlines, providing insights and updates on compliance activities and trends.
- Comply fully and consistently with all company policies and procedures, with local and federal laws as well as with the regulations applicable to our Industry, to maintain appropriate business and employment practices.
- May perform other duties and responsibilities as assigned, in accordance with the education and experience requirements contained in this document.
MINIMUM QUALIFICATIONS:
Education and Experience: Bachelor’s degree in a related field (e.g., Business, Health Administration, Legal Studies, Public Policy, or a similar discipline. At least three (3) years of related experience in compliance and/or regulatory affairs, preferably in the health insurance industry. Experience in project management with working knowledge of laws and/or regulations in areas of compliance and federal and state regulations.
"Proven experience may be replaced by previously established requirements."
Certifications / Licenses: N/A
Other: N/A
Languages:
Spanish – Advanced (writing, conversational, and comprehension)
English – Advanced (writing, conversational, and comprehension)
“We are an Equal Employment Opportunity Employer and take Affirmative Action to recruit Protected Veterans and Individuals with Disabilities.”
