Market Conduct Examiner I - Health & Pharmaceutical

Do you have professional experience in the health insurance industry or the pharmaceutical industry? Do you have professional experience investigating, auditing, or compliance? Do you have knowledge of health insurance laws and regulations? Are you able to communicate effectively in written and verbal form? If you answer yes to these questions, join our team as a Market Conduct Examiner in our Health & Life Division at the Utah Insurance Department!

The Market Conduct Examiner will primarily be tasked with conducting health insurance and pharmacy benefit manager investigations. This is a great opportunity for individuals who are detailed oriented, have investigative skills, and have a comprehensive knowledge of health insurance or pharmaceuticals, including pharmaceutical delivery. Most of the audit and investigation work is done independently with ample opportunities for collaboration with a larger team to discuss issues or policy questions as they arise. Organization skills as well as the ability to clearly communicate, verbally and in writing, compliance issues are integral to this position.

Principal Duties

• Investigate and respond to discoveries of non-compliance relating to health insurance and pharmacy benefit managers.
• Conduct, or participate in, market conduct examinations relating to health insurance and pharmacy benefit managers.
• Negotiate outcomes between consumers, insurers, licensees, and the department.
• Research issues and compile cases.
• Write thorough investigative reports.
• Assist the department's attorneys in developing your cases for hearing.
• Testify in court as needed.
• Communicate information and ideas clearly and concisely in writing, in person, and by phone.
• Read and understand information and data presented in order to draw fact-based conclusions.
• Research, interpret, and apply federal and state health insurance laws, regulations, policies, and procedures.

Minimum Qualifications

conducting audits

Requirements

Why You Should Join Our Team

This is an opportunity to make a difference by protecting Utah consumers by conducting market conduct investigations for compliance with applicable laws. Employees of the Utah Insurance Department enjoy a flexible work schedule to promote a healthy work / life balance, the satisfaction of serving the residents of our great state, and the chance to work from home up to 3 days a week. We offer great health benefits and retirement plans, along with generous paid time off.

The Agency

The Utah Insurance Department's mission is to foster a healthy insurance market by promoting fair and reasonable practices that ensure available, affordable, and reliable insurance products and services.

Working Conditions & Physical Requirements

Note : Your cover letter and resume must be attached to be considered for this position.

J-18808-Ljbffr