Compliance Analyst - Health Insurance Plans (Hybrid)

Virginia State Corporation Commission; Richmond (VA); Hybrid; USD 60,278 - 66,000; Full time

Job summary

The Virginia State Corporation Commission's Health Benefit Exchange division seeks a Compliance Analyst - Health Insurance Plans to support the certification and regulatory compliance of health and dental plans on Virginia's health insurance marketplace. This role collaborates with carriers and SCC staff to ensure accurate filings and adherence to standards.

Applicants should have 2+ years in health insurance or compliance, a bachelor’s degree, and strong analytical and communication skills.

Qualifications

• 2+ years of related professional experience in health insurance or compliance.
• Bachelor’s degree required (in lieu of a degree, ~6 years of related experience).
• Knowledge of insurance terminology and filings is a plus.
• Ability to read, analyze, and interpret laws, regulations, and guidance.

Responsibilities

• Review, analyze, and complete annual certification compliance reviews of QHPs and QDPs.
• Review, monitor, analyze state and federal regulations and guidance regarding carrier compliance.
• Communicate with health and dental carriers regarding certification, compliance findings, and recommendations.
• Review and analyze carrier and plan data in collaboration with HBE and SCC Bureau of Insurance.
• Coordinate onboarding, offboarding, reporting, and maintenance of carrier access in the exchange platform.
• Coordinate with Bureau of Insurance on concerns found during reviews and make recertification/decertification recommendations.
• Prepare and communicate carrier meeting agendas and meeting minutes.
• Prepare periodic reports for carriers.
• Perform related work as required.

Skills

Health insurance knowledge

Regulatory compliance

Data analysis

Communication skills

Education

Bachelor's degree

Job description

Starting Salary Range: $60,278 - $66,000

The State Corporation Commission’s (SCC) Health Benefit Exchange (HBE) division seeks a Compliance Analyst - Health Insurance Plans to join our team. This position supports the certification and compliance of health and dental plans on Virginia’s health insurance marketplace. The SCC offers a flexible hybrid work schedule, on-the-job training, and professional development opportunities. More information about Virginia’s Insurance Marketplace, a service of the Health Benefit Exchange, may be found at marketplace.virginia.gov.

• Review, analyze, and complete annual certification compliance reviews of Qualified Health Plans (QHPs) and Qualified Dental Plans (QDPs).
• Review, monitor, analyze state and federal regulations and guidance regarding carrier compliance.
• Communicate with health and dental carriers regarding carrier certification, compliance findings, operational issues, and recommendations for enhancements.
• Review and analyze carrier and plan-related data in collaboration with others in the HBE and the SCC’s Bureau of Insurance.
• Coordinate and monitor carrier onboarding, offboarding, reporting, and maintenance of carrier’s access and information in the exchange platform.
• Coordinate with the SCC’s Bureau of Insurance on concerns found during compliance reviews and make recommendations accordingly for plan recertification and decertification.
• Prepare and communicate carrier meeting agendas and meeting minutes.
• Prepare periodic reports for carriers.
• Perform related work as required.

Preferred Qualifications

• 2 or more years of related professional experience in health insurance or compliance and a bachelor’s degree.
• In lieu of a bachelor’s degree, approximately 6 years of related experience.
• Knowledge of insurance terminology, health insurance plans, form and rate filings, and/or Virginia rules and regulations is a plus.
• Ability to read, analyze and interpret laws, regulations, and guidance.
• Ability think critically and apply analytical skills.
• Strong verbal and written communication skills.
• Exceptional attention to detail.
• Ability to prioritize and meet deadlines.Ability to multitask and adapt to changing priorities in a dynamic environment.
• Ability to maintain effective, professional working relationships with SCC staff, industry personnel, and the general public.

How to Apply

Interested candidates are strongly encouraged to apply by June 5, 2026.

Qualified internal and external candidates are encouraged to apply. If you are an external candidate, apply on the SCC Career Center at https://careercenter.scc.virginia.gov. If you are an internal candidate, apply using eSCC (Oracle) - iRecruitment Employee Candidate.