Aetna Prod & Reg Apprvls Cnslt in High Point, North Carolina
Req ID: 54616BR
This position can be located in any Aetna location and is open to existing WAH
The State Filing Consultant (Regulatory Analyst) will be responsible for the preparation of regulatory filing submissions, negotiations, and compliance activities as they relate to Aetna products and programs. The consultant will determine if business and/or operational changes have regulatory impact, prepare materials as necessary (e.g., Certificates of Coverage and Schedules of Benefits, cover letters, checklists, certifications) to comply with state and federal regulatory requirements. They will then negotiate and monitor the approval process
Fundamental Components:Responsibilities of the State Filing Consultant (Regulatory Analyst) position include, but are not limited to:
Analyze insurance laws and regulations, determine applicability to Aetna products and programs, draft language that meets regulatory requirements, and prepare, submit, and negotiate filing approvals. Promote Compliance as a Core Competency while enforcing compliance with state/federal laws and regulations, risk management policies and company policies affecting Aetna business. Monitor industry and regulatory trends to identify potential risk factors and the need for change.Manage multiple priorities and filings under tight deadlines to advance speed-to-market expectations.Adhere to standard work flow processes on work assignments.Proactively notify business areas of regulatory requirements and changes, and assist the business areas in coordination of implementation. Build effective relationships with state and federal regulators, as well as internal business clients.
BACKGROUND/EXPERIENCE desired:Exposure and proficiency with the SERFF filing system (unless internal to the organization). Strong understanding of Specialty (student health, dental, vision, stop loss) and Medical products in large and small group - In-depth knowledge of the regulatory insurance environmentExcellent written and verbal communication skills and ability to interact effectively with different audiences.
The highest level of education desired for candidates in this position is a Bachelor's degree or equivalent experience.
LICENSES AND CERTIFICATIONS
Legal/Paralegal Certificate is desired
Claims/Associate Life and Health Claims is desired
Functional - Legal/Product and regulatory filings/1-3 Years
Functional - Products-Dental//1-3 Years
Functional - Products-Medical//1-3 Years
Technical - Desktop Tools//1-3 Years/Power User
General Business/Applying Reasoned Judgment/ADVANCED
Leadership/Collaborating for Results/FOUNDATION
Service/Working Across Boundaries/FOUNDATION
ADDITIONAL JOB INFORMATION
Aetna is about more than just doing a job. This is our opportunity to re-shape healthcare for America and across the globe. We are developing solutions to improve the quality and affordability of healthcare. What we do will benefit generations to come.
We care about each other, our customers and our communities. We are inspired to make a difference, and we are committed to integrity and excellence.
Together we will empower people to live healthier lives.
Aetna is an equal opportunity & affirmative action employer. All qualified applicants will receive consideration for employment regardless of personal characteristics or status. We take affirmative action to recruit, select and develop women, people of color, veterans and individuals with disabilities.
We are a company built on excellence. We have a culture that values growth, achievement and diversity and a workplace where your voice can be heard.
Benefit eligibility may vary by position. Click here to review the benefits associated with this position.
Aetna takes our candidates's data privacy seriously. At no time will any Aetna recruiter or employee request any financial or personal information (Social Security Number, Credit card information for direct deposit, etc.) from you via e-mail. Any requests for information will be discussed prior and will be conducted through a secure website provided by the recruiter. Should you be asked for such information, please notify us immediately.
Job Function: Legal
Aetna is an Equal Opportunity/Affirmative Action employer. All qualified applicants will receive consideration for employment without regard to race, color, religion, sex, sexual orientation, gender identity, national origin, disability, or protected Veterans status.