Insurance Policy Specialist II

Description

The Health and Life Insurance and Managed Care Division of the Department of Insurance regulates insurance companies and health maintenance organizations offering various types of health and life insurance products. Through application of statutory requirements, the branch reviews policy forms, certificates, applications, rate filings, life settlements contracts and other forms as necessary to assure that the health and life products being offered in Kentucky meet the applicable statutory and regulatory standards.

We are looking for an Insurance Policy Specialist II to join our team of highly skilled professionals. As an Insurance Policy Specialist II, you will perform complex research, analysis or planning functions related to health insurance or life insurance programs (including mathematical and statistical analyses) and serve as a project leader; and perform other duties as required.

Responsibilities Include, But Are Not Limited To, The Following

• Performs complex research, analysis of Utilization Review and Independent Review Entities policy contract language in the Health and Life and Managed Care Division for compliance with state and federal laws and regulations.
• Identifies and addresses noncompliance or potential violations.
• Performs complex research and analysis related to health insurance including mathematical and statistical analysis of health insurance programs and reports submitted by insurers and utilization review entities, and Pharmacy Benefit Managers (PBM’s).
• Recommends related policy, procedures, and database needs.
• Identifies specific needs to address changes in statutes and regulations and recommends changes needed in procedural processes.
• Coordinates implementation of changes.
• Provides technical assistance to coworkers, professional organizations, and other government agencies, insurers and consumers.
• Serves as a leader of special projects.
• Performs other duties as assigned.
  
  

Other Preferred Skills And Abilities

• Attention to detail
• Excellent verbal and written communication skills
• Time management
• Teamwork
• Organizing skills
  
  

Reasons To Work For Us Include

• A 37.50 hour work week
• Paid Leave (Sick, Vacation, etc.) and Paid Holidays
• Training and Career Development Opportunities
• Educational and Tuition assistance
• A variety of affordable health, dental and vision Insurance options including HRA, HSA and FSA options
• Life Insurance
• Retirement
• Deferred Compensation
• Wellness Incentive Programs
• Employee Discounts on electronics, health and wellness, retail, travel, events, entertainment, services and education
• Telecommuting and flexible work schedules
  
  

Applicants must be currently authorized to work in the United States for any employer. If you are interested in a challenging yet rewarding career where you can make a positive impact in your community, we would love to review your application for the Insurance Policy Specialist II, with the Kentucky Department of Insurance.

Minimum Requirements

EDUCATION: Graduate of a college or university with an associate's degree.

EXPERIENCE, TRAINING, OR SKILLS: Four years of professional experience in property and casualty insurance, health insurance, life insurance claims/systems, research, planning, policy development, or administration functions for an insurance company or insurance regulatory agency.

Substitute EDUCATION for EXPERIENCE: Additional education in planning, public administration, business administration, actuarial science, mathematics, statistics, economics, or a related field will substitute for the required experience on a year-for-year basis up to two years OR Successful completion of two actuarial examinations from either the Society of Actuaries or the Casualty Actuarial Society will substitute for the required experience.

Substitute EXPERIENCE for EDUCATION: Additional experience in the preparation of insurance reports, audits, actuarial loss reserving, property and casualty insurance, health insurance, life insurance claims/systems, research, planning, policy development, or administration functions for an insurance company, insurance agency, or insurance regulatory agency will substitute for the required education on a year-for-year basis.

SPECIAL REQUIREMENTS (AGE, LICENSURE, REGULATION, ETC.): NONE

Working Conditions

Duties are typically performed in an office setting.