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Compliance & Regulatory
WellCare - Regulatory Careers

Regulatory & Compliance Specialist - Senior Job

Full Job Title: Regulatory/Compliance Specialist, Senior*

Job Number: 1702575

Locations:
Chicago, IL
Belleville, IL
Waukegan, IL
Springfield, IL
Moline, IL

Date Posted: 10-2-2017

Participates in and supports companywide corporate ethics and compliance programs, the Trust Program, and the ongoing review and approval of all marketing materials.
Essential Functions:
  • Performs comprehensive, complex regulatory analyses, including the review, summarization and dissemination of key regulatory updates and changes.
  • Drives policy and procedure process, including the design, review, cataloging, dissemination and annual updating of corporate policies and procedures.
  • Coordinates review and investigation of Trust Program reports.
  • Coordinates site visits by Federal and State regulators.
  • Develops regulatory process flows, including the documentation of departmental processes, report generation, and process improvement
  • Provides project leadership for compliance-related audits, including the review of departmental documents, interview of departmental staff, summarizing results and implementing recommendations.
  • Supports the design, development and implementation of the Regulatory database ensuring all key departmental processes are captured in the database for tracking and trending purposes.
  • Supports management of the regulatory communications process ensuring all regulatory communications/updates are received, summarized, catalogued, disseminated and acted upon.
  • Coordinates filing of regulatory forms, reports, etc. and provides guidance to other departments in understanding and complying with regulatory requirements.
  • Tracks all issues referred to the Regulatory Affairs Department up to and including resolution.
  • Represents the health plan at federal, state, and local government meetings.
Candidate Education / Experience:
  • BA/BS Degree
  • 7 years experience in Managed Care/Health Insurance or a Master's Degree in Business, Public Health, Health Care Administration, or related field.
  • State or Federal Managed Care Compliance experience.

Technical Skills:

  • Solid knowledge of Microsoft Outlook, Excel, Word, and Access.

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Last Updated On: 12/9/2015