Insurance Manager – Plan Management & ACA Forms

Insurance Manager – Plan Management & ACA Forms

Starting Salary Range: $101,504 - $110,000

The State Corporation Commission’s(“SCC”) Bureau of Insurance(“BOI”) seeks an experienced insurance professional to manage the Plan Management and ACA Forms Section in the Life & Health Insurance Division. This Manager position oversees the work of seven (7) insurance professionals. The selected candidate for this position will be responsible for reviewing individual and small group Affordable Care Act(“ACA”) form filings, as well as large group health and other group accident and sickness form and rate filings, to ensure that they are compliant with Virginia's laws and regulations.

This section is also responsible for handling all ACA Plan Management responsibilities to ensure that plans meet all federal and state requirements before recommending certification to the SCC’s Health Benefit Exchange(“HBE”). This Manager will lead, coach, mentor, develop, and evaluate staff and ensure that the work is performed in a timely, thorough, and consistent manner. The Insurance Manager for Plan Management and ACA Forms position offers a hybrid work schedule (typically 2 days in office and 3 telework days each week) as well as a variety of professional development and training opportunities.

Essential functions and responsibilities of the Insurance Manager for Plan Management and ACA Forms include:

• Manage the work of the Plan Management and ACA Forms Section, which is responsible for the review of filings as well as binder reviews to fulfill Plan Management responsibilities
• Prepare annual communications to industry about ACA form and rate filing deadlines and other pertinent filing information and circulate each document for internal feedback and approvals
• Collaborate with the team, BOI leadership, and internal counsel to resolve complex analytical or technical issues
• Serve as a liaison and conduct discussions with the senior leadership of regulated entities regarding assigned filings
• Serve as a subject matter expert for the Plan Management and ACA Forms section
• Serve as a working manager by handling filings as primary reviewer
• Communicate orally and in writing with regulators, industry and the general public in response to oral and written requests for information regarding team’s assigned filings, ACA form and Plan Management related issues
• Coordinate reviews of form filings and plan management binders with the HBE, the Virginia Department of Health, and the Center for Medicaid Services as needed
• Lead, manage, coach, develop, train, mentor, and evaluate assigned staff
• Coordinate and monitor the team's workload, including assigning form and rate filings and related projects to ensure fair and equitable distribution among staff based on training and experience
• Manage and oversee training and development of staff within the Plan Management and ACA Forms section, including auditing form and group rate filings handled by staff to address training needs identified through these audits
• Oversee updates to knowledge transfer guides and internal and external checklists at least annually to support staff training
• Participate in the development, drafting, and review of legislation, administrative letters/orders, and other regulatory guidance
• Lead and participate in internal meetings and participate in National Association of Insurance Commissioners(“NAIC”) work as needed
• Perform related work as requested

• Eight (8) or more years of professional experience in health insurance and the ACA; and considerable experience managing staff
• Collaborative leader who values the contributions of others and creates a culture where staff is motivated to do their best
• Thorough knowledge of insurance terminology, laws, and regulations
• Demonstrates effective communication skills and clearly communicates ideas and decisions both verbally and in writing
• Ability to effectively lead, manage, coach, develop, train, and evaluate new and existing staff
• Ability to read and review insurance policies, related forms, and information related to form and rate filings, and to read, understand, and interpret sections of the Virginia Insurance and Administrative Codes and correctly determine their applicability to submitted form and rate filings
• Ability to effectively analyze issues or situations, consider viable options, and make sound recommendations
• Ability to proactively recommend changes and to lead process improvement efforts
• Ability to meet tight deadlines
• Ability to establish and maintain effective working relationships with Commission staff, industry personnel and other state and federal agencies