Job Information
Medical Mutual of Ohio Certificate Compliance Manager in Ohio
This is a remote opportunity. Note, quarterly on-site requirement in Brooklyn, Ohio. Ohio residents preferred.
Founded in 1934, Medical Mutual is the oldest and one of the largest health insurance companies based in Ohio. We provide peace of mind to more than 1.2 million members through our high-quality health, life, disability, dental, vision and indemnity plans. We offer fully insured and self-funded group coverage, including stop loss, as well as Medicare Advantage, Medicare Supplement, and individual plans.
Manages certificate production and product filings. Support the Company’s initiatives to introduce new, and update existing, product offerings, by leading a team that creates state and federally compliant policy forms, obtains the necessary state and/or CMS approval of those forms and ensures that various state-required responses and reporting are submitted on a timely basis.
Responsibilities
· Manages the Certificate Development staff and their work. Oversees the creation of plan documents for individual and all-size group products.
· Leads certificate/policy state filing efforts covering a wide range of products on behalf of Medical Mutual and its subsidiaries. Negotiates changes or acceptance of language with Departments of Insurance, to achieve filing approval. Ensures that various reports required by state Departments of Insurance throughout each year are submitted on a timely basis.
· Researches and analyzes current and proposed state and federal laws and guidance that may impact plan documents, to ensure that benefits and provisions of new and existing plan documents are compliant and, with respect to fully insured plans, the plan documents fall within variability of prior approved state filings. Amends plan document language for new and existing customers, as needed.
· Collaborates with cross-functional business partners, to ensure plan documents are consistent with plan operation and proactively builds relationships with state and federal regulators.
· Performs other duties as assigned.
Qualifications
Education and Experience
· Bachelor’s degree in business administration, English, Legal or related field, or equivalent combination of training and experience.
· Eight years’ experience in the health insurance field. Three years of which are in a leadership capacity preferred.
Technical Skills and Knowledge
· Demonstrated ability to describe in writing a highly technical process in plain language.
· Thorough understanding of contracts, insurance policies and health care benefits.
· In-depth knowledge of insurance statutes and regulations.
· MS Office.
Medical Mutual is looking to grow our team! We truly value and respect the talents and abilities of all of our employees. That's why we offer an exceptional package that includes:
A Great Place to Work:
We will provide the equipment you need for this role, including a laptop, monitors, keyboard, mouse and headset.
Whether you are working remote or in the office, employees have access to on-site fitness centers at many locations, or a gym membership reimbursement when there is no Medical Mutual facility available. Enjoy the use of weights, cardio machines, locker rooms, classes and more.
On-site cafeteria, serving hot breakfast and lunch, at the Brooklyn, OH headquarters.
Discounts at many places in and around town, just for being a Medical Mutual team member.
The opportunity to earn cash rewards for shopping with our customers.
Business casual attire, including jeans.
Excellent Benefits and Compensation:
Employee bonus program.
401(k) with company match up to 4% and an additional company contribution.
Health Savings Account with a company matching contribution.
Excellent medical, dental, vision, life and disability insurance — insurance is what we do best, and we make affordable coverage for our team a priority.
Access to an Employee Assistance Program, which includes professional counseling, personal and professional coaching, self-help resources and assistance with work/life benefits.
Company holidays and up to 16 PTO days during the first year of employment with options to carry over unused PTO time.
After 120 days of service, parental leave for eligible employees who become parents through maternity, paternity or adoption.
An Investment in You:
Career development programs and classes.
Mentoring and coaching to help you advance in your career.
Tuition reimbursement up to $5,250 per year, the IRS maximum.
Diverse, inclusive and welcoming culture with Business Resource Groups.
About Medical Mutual:
Medical Mutual’s status as a mutual company means we are owned by our policyholders, not stockholders, so we don’t answer to Wall Street analysts or pay dividends to investors. Instead, we focus on developing products and services that allow us to better serve our customers and the communities around us.
There’s a good chance you already know many of our Medical Mutual customers. As the official insurer of everything you love, we are trusted by businesses and nonprofit organizations throughout Ohio to provide high-quality health, life, disability, dental, vision and indemnity plans. We offer fully insured and self-funded group coverage, including stop loss, as well as Medicare Advantage, Medicare Supplement and individual plans. Our plans provide peace of mind to more than 1.2 million Ohioans.
We’re not just one of the largest health insurance companies based in Ohio, we’re also the longest running. Founded in 1934, we’re proud of our rich history with the communities where we live and work.
At Medical Mutual and its family of companies we celebrate differences and are mutually invested in our employees and our community. We are proud to be an Equal Employment Opportunity and Affirmative Action Employer. Qualified applicants will receive consideration for employment regardless of race, color, religion, sex, sexual orientation, gender perception or identity, national origin, age, marital status, veteran status, or disability status.
We maintain a drug-free workplace and perform pre-employment substance abuse and nicotine testing.
Title: Certificate Compliance Manager
Location: Ohio
Requisition ID: 2400165