Summary: This position will be responsible for the oversight and direction for coordinating responses for compliance cases and quality control reviews as outlined in the SRA (Appendix IV). Through direction of the SVP/General Counsel, responsible for the design and implementation of review programs, policies and practices to ensure compliance with federal, state and local regulatory requirements. Provides guidance, training, and supervision of Quality Control/Compliance Coordinators and Advisors.|
(This position may be filled at the higher Assistant Vice President level depending on experience and skills of selected applicant.)
Essential Duties and Responsibilities:
Required Education, Experience, and Skills
- Develops, maintains and revises compliance and quality control review policies and procedures for the general operation of both the Quality Control and Compliance program and its related activities to prevent illegal, unethical or improper claims review process conduct. Manages the day-to-day operation of the program.
- Collaborates with Branch Manager, Claims Manager and Claims Supervisors to (a) ensure quality control reviews are conducted in a timely manner (and such collaboration is essential when sales, underwriting and claims staff assist with quality control reviews) and (b) direct compliance cases to appropriate existing channels for investigation and resolution. Consults with SVP/General Counsel as needed to resolve difficult compliance issues.
- Responds to alleged violations of rules, regulations, policies and procedures by evaluating or recommending the initiation of the quality control review investigation procedures. Develops and oversees a system for uniform handling of such violations.
- Monitors and coordinates quality control and compliance activities to remain abreast of the status of all activities and to identify trends.
- Identifies potential areas of compliance and quality control review vulnerability and risk; develops/implements corrective action plans for resolution of problematic issues, and provides general guidance on how to avoid or deal with similar situations in the future.
- Provides quality control and compliance reports to SVP/General Counsel on a regular basis, and as directed or requested.
- Ensures proper reporting of quality control review violations or potential violations to duly authorized enforcement agencies as appropriate and/or required.
- Responsible for supervision and training of Compliance Coordinators within this district.
- Assists with preparation and submittal of annual Quality Control Plan and Report with SRA (Plan of Operations) as requested.
- Monitors and reports, with the General Counsel, all potential misrepresentations, fraud, waste and abuse.
- Attends and participates in seminars and education to ensure current knowledge of federal, state and local regulatory rules and requirements is maintained.
- Other duties as assigned.
Preferred Education and Experience
- 5 or more years of crop adjusting or compliance experience
- Strong customer service skills
- Strong working knowledge of industry rules, regulations and procedures
- Ability to lead and supervise others
- Strong verbal and written communication skills
- Strong analytical skills
- Self-starter and able to work independently, as well as collaboratively
- Ability to multi-task and prioritize/de-prioritize items accordingly
- Strong independent, ethical judgment
- Computer knowledge including Office, Windows, EASYjuster Pro
Travel Required: Approximately 10%
- Bachelor’s Degree in agriculture
- Agricultural background
- QC/Compliance background
- Management experience