Specialist, Contract Compliance II

Palmetto GBA, LLC; New York (NY); On-site; USD 80,000 - 110,000; Full time

Benefits offered by this job

Subsidized health plans

Dental and vision coverage

401k retirement with company match

Life Insurance

Paid Time Off

On-site cafeterias and fitness centers

Education Assistance

Service Recognition

National discounts

Job summary

BlueCross BlueShield of South Carolina is seeking a contracts and compliance specialist to research state insurance statutes, regulations, and bulletins, prepare filings for approvals, and coordinate with legal and compliance teams. The role involves contract drafting, redlining, and end-to-end negotiations to align with business objectives.

The position requires 5 years in insurance with 4 in compliance/research, and a Bachelor’s degree.

Qualifications

• Bachelor’s degree required.
• Degree equivalency: 4 years related work experience or Associate’s + 2 years.
• 5 years insurance experience, 4 in compliance and research.
• Strong knowledge of insurance statutes and ERISA.
• Strong written and verbal communication skills.
• Proficient with Microsoft Office.

Responsibilities

• Researches state statutes, regulations, and bulletins for policy form filings; secures department approvals.
• Drafts and reviews contracts; identifies deficiencies and coordinates with legal staff.
• Prepares and files reports and corporate documents for state/federal agencies.
• Operates policy and certificate issue systems; ensures correct benefit selections and print logic.
• Communicates regulatory bulletins to compliance and product staff; summarises directives.
• Logs and distributes complaints; updates procedures to improve performance.
• Researches NAIC models and state requirements as requested.
• Redlines and negotiates contract language to mitigate risk.
• Manages full-cycle contract negotiations from drafting to execution.
• Uses CLM systems to manage contracts through lifecycle.

Skills

Insurance statutes & regulations

ERISA knowledge

Written & verbal communication

Education

Bachelor's degree

Business Administration or related field preferred

Tools

Microsoft Office

Job description

Summary

Researches and interprets insurance laws pertaining to division products form filings and obtains approval from the various state insurance departments. Communicates impact of insurance bulletins, circulars, and directives to appropriate departments and ensures compliance with all laws and regulations.

Description

This is a full time onsite position reporting to 4101 Percival Road Columbia, SC.

What You’ll Do:

• Researches insurance statutes, regulations, and bulletins for policy form filings. Prepares formal contract filings and secures insurance department approval. Performs preliminary research on state and federal requirements pertaining to new market opportunities. Advises management of potential problem areas pertaining to emerging opportunities and current core products.
• Reviews, revises, and assists in drafting marketing, reinsurance, and administrative agreements. Identifies contractual deficiencies in written agreements and recommends appropriate revision. Coordinates the review of all contracts with Companion’s legal staff, if necessary.
• Prepares, maintains, and files reports and corporate documents that pertain to core products and required by various state insurance departments and federal agencies.
• Maintains and operates policy and certificate issue systems. Designs and programs paragraph logic and codes to ensure proper benefit selections and state variables print correctly. Troubleshoots the systems to ensure policy and certificate systems remain uninterrupted.
• Communicates impact of insurance department bulletins and federal opinions to compliance manager and specialty product staff, and prepares response when required. Communicates the compliance department’s summary of pertinent insurance department bulletins, circulars, and directives and all federal opinions and directives to appropriate company personnel. Provides clarification regarding technical interpretations.
• Receives, logs, and distributes complaints (insurance department and consumer) pertaining to core products for response and follow up to ensure timely response. Develops, updates, and maintains procedure manuals to ensure maximum job performance and timeliness.
• Researches state insurance statutes, regulations, bulletins, and NAIC models as requested by compliance manager, companion’s legal department, and specialty product staff.
• Contract Redlining and Review: Review, revise, and negotiate contract language to mitigate risk and align with business objectives.
• Full-Cycle Contract Negotiation: Manage contract negotiations from initial drafting through execution, collaborating with internal stakeholders and external parties to achieve mutually beneficial agreements.
• CLM (Contract Lifecycle Management) Systems: Utilize CLM platforms to manage contract creation, routing, approvals, execution, storage, and ongoing compliance throughout the contract lifecycle.

What You’ll Need:

Required Education: Bachelor’s

Degree Equivalency: 4 years job related work experience or Associate’s and 2 years job related work experience

Required Work Experience: 5 years insurance experience, 4 of which must be in insurance compliance and insurance research.

Required Skills and Abilities: Strong knowledge of insurance statutes and regulations and ERISA. Strong written and verbal communication skills.

Required Software and Other Tools: Microsoft Office.

Preferred Education: Bachelor’s degree- Business Administration or other related field

Preferred Work Experience: 5 years-experience in insurance compliance and insurance research.

Preferred Skills and Abilities: Ability to work under minimal supervision.

Work Environment: Typical office environment.

Our Comprehensive Benefits Package Includes The Following

We offer our employees great benefits and rewards. You will be eligible to participate in the benefits at the first of the month following 28 days of employment:

• Subsidized health plans, dental and vision coverage
• 401k retirement savings plan with company match
• Life Insurance
• Paid Time Off (PTO)
• On-site cafeterias and fitness centers in major locations
• Education Assistance
• Service Recognition
• National discounts to movies, theaters, zoos, theme parks and more

What We Can Do for You:

We understand the value of a diverse and inclusive workplace and strive to be an employer where employees across all spectrums have the opportunity to develop their skills, advance their careers and contribute their unique abilities to the growth of our company.

Equal Employment Opportunity Statement

BlueCross BlueShield of South Carolina and our subsidiary companies maintain a continuing policy of nondiscrimination in employment to promote employment opportunities for persons regardless of age, race, color, national origin, sex, religion, veteran status, disability, weight, sexual orientation, gender identity, genetic information or any other legally protected status. Additionally, as a federal contractor, the company maintains affirmative action programs to promote employment opportunities for individuals with disabilitiesand protected veterans. It is our policy to provide equal opportunities in all phases of the employment process and to comply with applicable federal, state and local laws and regulations.

We are committed to working with and providing reasonable accommodations to individuals with disabilities, pregnant individuals, individuals with pregnancy-related conditions, and individuals needing accommodations for sincerely held religious beliefs, provided that those accommodations do not impose an undue hardship on the Company.

If you need special assistance or an accommodation while seeking employment, please email [e-mail] or call 800-288-2227, ext. 47480 with the nature of your request. We will make a determination regarding your request for reasonable accommodation on a case-by-case basis.

We participate in E-Verify and comply with the Pay Transparency Nondiscrimination Provision. We are an Equal Opportunity Employer. Here’s moreinformation.

Some states have required notifications. Here’s more information.

Equal Employment Opportunity Statement

BlueCross BlueShield of South Carolina and our subsidiary companies maintain a continuing policy of nondiscrimination in employment to promote employment opportunities for persons regardless of age, race, color, national origin, sex, religion, veteran status, disability, weight, sexual orientation, gender identity, genetic information or any other legally protected status. Additionally, as a federal contractor, the company maintains affirmative action programs to promote employment opportunities for individuals with disabilitiesand protected veterans. It is our policy to provide equal opportunities in all phases of the employment process and to comply with applicable federal, state and local laws and regulations.

We are committed to working with and providing reasonable accommodations to individuals with disabilities, pregnant individuals, individuals with pregnancy-related conditions, and individuals needing accommodations for sincerely held religious beliefs, provided that those accommodations do not impose an undue hardship on the Company.

If you need special assistance or an accommodation while seeking employment, please email [e-mail] or call 800-288-2227, ext. 47480 with the nature of your request. We will make a determination regarding your request for reasonable accommodation on a case‑by‑case basis.

We participate in E-Verify and comply with the Pay Transparency Nondiscrimination Provision. We are an Equal Opportunity Employer. Here’s moreinformation.

Some states have required notifications. Here’s more information.