Aetna-Sr. Compliance Consultant

Aetna-Sr. Compliance Consultant

[PLEASE NOTE THAT THIS IS A 12-MONTH CONTRACT ROLE]

Job Group Summary
Whether it\u0027s complying with changing regulations and laws, adhering to ethical guidelines or preventing fraud, our Legal Department is the driving force behind it. Their work helps us meet the highest standards of business conduct and integrity in all we do.

Family Summary/Mission
Promotes and enforces compliance with state/federal laws and regulations and related-company policies (including the Aetna Code of Conduct) affecting Aetna businesses and encourages high business standards in order to advance company objectives, benefit the company\u0027s customers, employees and shareholders, and protect the company\u0027s reputation.

Responsibilities include auditing, investigating, training/education and enforcement ongoing consultation on compliance issues impacting businesses interfacing with industry groups and regulators on compliance with laws and regulators monitoring and reporting on adherence to compliance controls recommending and helping businesses to implement compliance controls

Position Summary/Mission

  • Assisting and supporting the RCM: to manage AI’s legal, regulatory and compliance requirements in the manner directed by, and to the standards required by, the Chief Compliance Officer; to carry out such discrete or project-type tasks set by the Chief Compliance Officer;
  • to ensure that a culture of compliance is developed and maintained throughout AI;
  • to deliver clear, accurate and proportionate advice, as a matter of routine, to relevant colleagues in good time, and help colleagues to do the same;
  • to identify and lead changes to AI compliance and regulatory framework where required by law, regulation or good practice; to enjoy and maintain the full confidence of related control functions (including without limitation Internal Audit and Legal); and to proactively liaise with colleagues to identify and mitigate issues which have or may have a material adverse effect on AI or the wider business issues which have or may have a material adverse effect on AI or the wider business.

Fundamental Components & Physical Requirements

  • Supporting the RCM to advise on, monitor and implement mitigation strategies in respect of compliance and regulatory issues;
  • Preparing materials to be presented to the senior management team and other relevant parties on compliance and regulatory issues;
  • Assisting with regulatory reporting; Developing a professional relationship with all relevant regulatory bodies;
  • Ensuring adherence to Best Practice Processes, Service Standards and to all relevant statutory or regulatory requirements, including treating customers fairly (TCF) and support any TCF initiatives;
  • Working to improve Best Practice procedures and standards; Promoting and enforcing Aetna\u0027s Code of Conduct and AI compliance policies;
  • Identify and researching significant legislative initiatives and assessing impact on business operations in conjunction with the RCM.

Education and Certification Requirements

  • Degree or equivalent experience

Background & Experience Desired

  • Proficient in MS-Office.
  • Proven track record in drafting, interpreting, and implementing insurance
  • contract frameworks and settling legal disputes relating to contract wordings is desirable.
  • Previous experience in the insurance industry is desirable.
  • Experience in a compliance or legal environment with particular emphasis on practical knowledge of relevant law, regulation and best practices as they apply to insurance.

Additional Information

  • Requires the following behavioral skills.
  • Excellent communicator.
  • Enjoys challenge.
  • Motivated to deliver the right answer in the right timeframe
  • Works Proactively, either as a part of a team or alone.
  • Strong negotiator.
  • Works well under pressure and is a pro-active self-starter.

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