This position is a member of the Rates, Forms and Provider Networks management team. Reporting to the Forms Compliance Manager, the Health Forms Manager is responsible for the timely, consistent, and efficient review of health plan form filings submitted by the insurance industry. This includes ensuring that state and federal statutes, rules, and case law are accurately reflected in the processes, procedures, and review criteria produced by professional staff for use on reviewing health plan forms and depended upon by Insurance companies when developing health plans and submitting form filings for use in Washington State. This position focuses on the implementation of the Affordable Care Act. The successful incumbent will possess the ability to adapt to ever changing regulatory landscape, lead with empathy, and be willing to take appropriate risks.

Duties
Develops short-term strategic (1-3 years) operating plans, goals, and objections for the regulation of health plan form filings and implements tactics for the ongoing review of health plan form filings.
Directs and controls the development and implementation of policies, procedures, regulation, and statutes for the regulation of health plan forms.
Directly accountable for the overall performance of the Health Forms Unit.
Directs the review of health plan forms submitted by regulated entities.
Assures appropriate and optimum use of the organizations resources and enhances the effectiveness of employees through timely appraisal and professional development opportunities.
Independently identifies undecided policy and legal issues, directs questions to the appropriate subject matter experts, and develops and implements tactics to address existing gaps, including rulemaking and legislative proposals.
Represents the OIC on a local and national level, speaking on behalf of the agency, and participating on National Association of Insurance Commissioners (NAIC) task forces and work groups.
Supervise the Health Forms Unit Functional Program Analysts who perform the following in their review of health plan filings for all health plan issuers (regulated entities), including but not limited to:

Developing performance expectations and conducting performance evaluations, including individual development, and training plans.
Assigning, planning, instructing, and checking the work of assigned staff; coaching and recognizing staff.
Approving/disapproving request for outside employment, leave, and overtime and/or exchange time; recommending or approving/disapproving (as delegated) employee training requests.
Conducting supervisory fact-findings into alleged misconduct and/or performance deficiencies, taking appropriate corrective action, and/or disciplinary action up through a Letter of Reprimand. (For discipline affecting pay of individuals, make a recommendation for consideration to the appointing authority.)

This is a Washington Management Service (Band 02) position. The annual salary range is between $94,008 – $105,816. Wage/salary depends on qualifications.

Qualifications
A Bachelor’s degree from an accredited college or university whose accreditation is recognized by the U.S. Department of Education and the Council for Higher Education Accreditation (CHEA). (Analysis of health plan forms or supervisory work experience, in addition to what is required below, may be substituted – one year for each year of education)
AND

Two(2) years’ experience in each of the following:
Analyzing insurance forms (contracts or policies), and basic knowledge of health insurance to include understanding of common terms, coverages, and functions.
Supervisory experience of professional level staff.
Interpreting federal or state law and rules, and case law, in an insurance related position. Insurance related positions include, but are not limited to, claim handling, underwriting, compliance, auditing, training, product design or benefit design.
Preferred/Desired Qualifications of this position include:

Advanced degree in law.
Two (2) years’ experience with the System for Electronic Rate and Form Filings (SERFF).
Currently possess or actively pursuing one or more insurance focused professional designations such as Certified Insurance Examiner (CIE), Healthcare Compliance Professional (HCP), Health Insurance Associate (HIA), Associate Insurance Regulatory Compliance (AIRC), Associate Professional in Insurance Regulation (APIR) or a similar designation program.

Contact us: For inquiries about this position, please contact Treese Beckett at (360) 725-7011.