[Remote] Market Conduct Examiner (Health and PBM)
Note: The job is a remote job and is open to candidates in USA. RSM US LLP is a leading provider of professional services to the middle market globally, dedicated to empowering clients and their employees. The Market Conduct Examiner will perform reviews of insurance companies’ operations to ensure compliance with state regulations, analyze documentation, and prepare reports while providing guidance on insurance laws and regulations.
Responsibilities
- Perform comprehensive, targeted and risk focused market conduct examinations to determine compliance with states’ insurance statutes and regulations on behalf of state insurance departments
- Review and assess insurance company’s documentation and data to determine compliance with states’ insurance statutes and regulations
- Draft examination work papers in an organized manner for supervisory review
- Assist with the preparation of reports, exhibits, and other supporting documentation and schedules that detail a company’s compliance with insurance statutes and regulations and recommend solutions
- Submit draft examination reports and other deliverables for supervisory review
- Recommend/document actions to ensure compliance with insurance statutes and regulations
- Must possess knowledge of and provide guidance of insurance laws, rules, and regulations
- Review and analyze new, proposed, or revised laws, regulations, policies, and procedures in order to determine compliance with states’ insurance statutes and regulations and interpret their meaning and determine impact to the insurance company
- Analyze reports and records relating to specific and overall operations of insurance companies; prepare clear, complete, concise, and informative compliance reports of condition of insurance companies for supervisory review
- Consistently enhance knowledge of principles, practices, techniques, and methods of insurance examination and regulations; insurance laws and Insurance Commissioner’s rulings; and related Attorney General Opinions and court decisions; insurance company practices; statistical sampling procedures; basic mathematics
- Complete examination work in the required state software platform
- Ensure all deadlines presented by examination workplan schedule and PBM management are met
Skills
- Bachelor's Degree in Business, Risk Management, Accounting or Finance; MBA and/or professional certification/s preferred
- Minimum of 5+ years insurance experience with a State or Federal agency, insurance company, examination firm or with a public accounting firm as an internal or external auditor, adjuster, compliance professional or examiner
- Insurance industry experience is a must
- Candidates must have completed or are pursuing professional insurance designations such as AIE/CIE, MCM, AIRC, FLMI, CPCU, or CLU
- PC skills, including experience in using software for producing presentations, spreadsheets, and project planning (skilled in TeamMate, ACL/Access, and MS Excel, Word and Power Point)
- Demonstrated history of project management experience
- Ability to interact with all levels including executives and senior managers
- Strong interpersonal, presentation, analytical and examination/audit skills
- Excellent organizational skills and the ability to prioritize multiple tasks, projects and assignments using effective time management skills
- Strong written and verbal communication skills are required
- Dynamic/flexible demeanor with exceptional client service skills
- Forward-thinking leader with a collaborative focus who can consult effectively with key constituents and become recognized as a valued resource
- Must be self-motivated, work well independently and possess a sense of urgency
- Skilled in team building and team development
- Flexibility for minimal travel
- Strong knowledge of and experience in Health Lines of Business, with an emphasis in the Affordable Care Act (ACA) and the Mental Health Parity and Addiction Equity Act (MHPAEA)
- Extensive experience with examination software TeamMate
- Moderate experience with ACL
Benefits
- Flexibility in your schedule
- Discretionary bonus based on firm and individual performance
Company Overview