Compliance Officer, Healthcare

Compliance Officer page is loaded## Compliance Officer locations:
Dallas, TXtime type:
Full time posted on:
Posted Todayjob requisition :
JR3524
** About Copeland
** Founded in 1962, Copeland Insurance Group is national Field Marketing Organization (FMO) focused on serving senior Americans with their life and health insurance needs and is a leader in providing quality service to agencies and independent agents. As part of Integrity, LLC, Copeland offers a suite of proprietary, innovative omnichannel solutions, empowering their agents and agencies with the best technology in the industry.
** Position Summary
** We are looking for a Compliance Officer to support the organization’s Health and Life & Annuities insurance sales activities. This individual will play a critical role in ensuring all insurance marketing and sales activities adhere to federal and state regulations, particularly those set forth by the Centers for Medicare & Medicaid Services (CMS) and state Departments of Insurance, as well as the requirements of the insurance providers whose products we sell.

This candidate should be knowledgeable of the various marketing and enrollment periods relative to compliance. This role directly supports the CEO of Copeland Insurance Group and the Chief Compliance Officer of Integrity Health and is responsible for day-to-day compliance operations at Copeland, including agent training, auditing, material reviews, and reporting. A key focus is the oversight of downline agents to ensure regulatory adherence across all field operations.

The person should have a general understanding of federal and state regulations related to the marketing and advertising of health and life insurance products, including Medicare, Medicare Advantage, Medicare Supplement, Prescription Drug Plans, Affordable Care Act (ACA), Final Expense, and other ancillary products. This position will collaborate with members of the Integrity Compliance and Enterprise Risk Management (ERM) teams to align with overall enterprise-wide strategies and objectives.
** Primary Responsibilities
*** Proactively monitor and report on the compliance activities of downline agents, including sales practices, event compliance, lead and referral generation, call monitoring, and other oversight activities as required
* Provide compliance updates to downline agents related to regulatory or carrier guidance and/or changes
* Support agents/agencies with compliance review of communications materials
* Collaborate with insurance carriers for successful agent complaint tracking, agent coaching, audits, HIPAA risk assessments, and corrective action plans
* Participate in monthly carrier compliance calls and provide reports on compliance monitoring activities and metrics
* In conjunction with Integrity Compliance, review marketing and communications materials for compliance, including consumer-facing and agent-facing materials
* Submit required marketing materials to carriers for approval
* File required marketing materials to the CMS Health Plan Management System (HPMS) and ensure adherence to filing and usage rules
* In conjunction with Integrity, ensure compliance at all Copeland offices including the completion of required training, policy management, adherence to Do Not Call registries, OIG/SAM exclusion screenings, issue reporting, and other tasks as required
* In conjunction with Integrity Legal, manage Business Associate Agreements (BAA) with applicable vendors
* Attendance at virtual Integrity Health and Life Council meetings
* Participation in and completion of annual Compliance Officer summit and annual Spring Training
* Work within the Integrity governance, risk, and compliance (GRC) platform to complete various privacy and IT risk assessments and related risk mitigation plans.
* Stay advised regarding relevant regulatory updates
* Collaborate with Integrity ERM team to mitigate risks for Copeland Insurance Group
* Collaborate effectively with management of Copeland, Integrity Health and Life segments, and other Integrity business unit compliance officers for assigned compliance initiatives and to achieve strategic objectives
* Travel monthly to Copeland offices for onsite compliance reviews
** Required Competencies
*** Thorough understanding of CMS guidelines and regulatory requirements for the sales and marketing of Medicare Advantage, Part D, Med Supp, ACA, End of Life plans, and other ancillary products
* Proven record of managing agent compliance, marketing reviews, and regulatory audits
* Ability to assess agent behavior and audit findings for compliance risks
* Strong written and verbal communication skills to train agents, report findings, and collaborate across departments and with carrier partners with the highest standards of professionalism and integrity
* Comfortable using technology platforms for compliance tracking, audit tools, and CMS submissions
* Ability to establish productive, trusting working relationships with individuals and teams both inside and outside the…