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Utilization Review Analyst

Recruitment #15-009640-0003

Introduction

The Maryland Insurance Administration (MIA) is an independent State agency that regulates Maryland’s insurance industry and protects consumers by monitoring and enforcing insurers’ and insurance professionals’ compliance with State law.  Through the diligence of a highly professional staff of market analysts, financial analysts, accountants, lawyers, law enforcement officers, actuaries, complaint investigators, and others, the MIA works to facilitate a strong and competitive insurance marketplace where consumers are well informed and treated fairly.  Staff members are subject matter experts who serve as a resource for lawmakers, consumers, and other public and private entities.  

The MIA is charged with a broad range of responsibilities including the licensure of insurance carriers and insurance producers (brokers/agents) operating in Maryland, the conduct of financial examinations of companies to monitor financial solvency, and the review and approval of rates and contract forms.  The MIA investigates reports of consumer fraud and consumer complaints about life, health, automobile, homeowners, and/or property insurance.  Insurance carriers are subject to market conduct examinations and other actions to monitor compliance with Maryland law.  The MIA also has a unit dedicated to consumer education and outreach, which participates in hundreds of events and reaches thousands of individual consumers annually. 

GRADE

Utilization Review Analyst I:    $38,880.00 - $61,691.00/Year (grade 14)

Utilization Review Analyst II:   $41,358.00 - $65,827.00/Year (grade 15)

Utilization Review Analyst III:  $44,017.00 - $70,265.00/Year (grade 16)

POSITION DUTIES

The Maryland Insurance Administration’s Life and Health Division is recruiting for a Utilization Review Analyst I, II, or III.  A Utilization Review Analyst reviews new, and renewal, Private Review Agent (PRA) applications and updates submitted by certified PRAs to determine compliance with Maryland laws and regulations.  This position provides written notification to PRA representatives concerning corrections required to bring applications and updates into compliance with relevant Maryland insurance laws and regulations.   

The incumbent reviews Medical Director applications for completeness, verifies credentials of applicants, and prepares written notifications to applicants of deficiencies.  This position interprets and applies knowledge of Maryland insurance laws to respond to inquiries from internal and external customers regarding PRA and Medical Director requirements.

MINIMUM QUALIFICATIONS

Utilization Review Analyst I:  

 

Education: Possession of a Bachelor’s degree from an accredited college or university. 

 

Experience: None

 

Note: Two years experience drafting or analyzing life or health insurance policy forms for a regulatory agency or licensed insurer; may substitute for the required education.  

 

Utilization Review Analyst II:

Education: Possession of a Bachelor’s degree from an accredited college or university. 

Experience: Two years experience drafting or analyzing life or health insurance policy forms for a regulatory agency or licensed insurer.

Note: The requirements indicated below are acceptable substitutions to the above minimum requirements:

 

1-    Four years experience drafting or analyzing life or health insurance policy forms for a regulatory agency or licensed insurer; or

2-    Three years of experience drafting or analyzing life or health insurance policy forms for a regulatory agency or licensed insurer, and productive activity toward a professional designation may substitute the required experience; or

3-    Possession of a bachelor’s degree and one year experience in drafting or analyzing life or health insurance policy forms for a regulatory agency or licensed insurer, and productive activity toward a professional designation; may substitute for the required experience; or

4-    Possession of a Juris Doctorate degree may substitute for the required experience.

 

 

Utilization Review Analyst III: 

 

Education: Possession of a Bachelor’s degree from an accredited college or university.  

 

Experience: Three years experience drafting or analyzing life or health insurance policy forms for a regulatory agency or licensed insurer.

 

Note: The requirements indicated below are acceptable substitutions to the above minimum requirements:

 

1- Five years experience drafting or analyzing life or health insurance policy forms for a regulatory agency or licensed insurer; or

2- Four years of experience drafting or analyzing life or health policy forms for a regulatory agency or licensed insurer and passing of 6 LOMA examinations or 6 AHIP examinations or 3 Society of Actuary’s Actuarial examinations or a combination of above; or

3- Possession of a Juris Doctorate degree and two years experience drafting or analyzing life or health insurance policy forms for a regulatory agency or licensed insurer.

BENEFITS

FURTHER INSTRUCTIONS

For immediate consideration, upload one WORD or PDF file, at the "Resume" tab, that contains:

1. a cover letter stating your interest and specific salary requirements; and

2. a current professional resume.

 

If you are unable to apply online, you may submit via mail.  Please be sure to include all documents listed above to ensure timely processing. Complete application packets may be mailed to:

Maryland Insurance Administration

Human Resources - Recruitment #:  15-009640-0003

200 St. Paul Place, Suite 2700

Baltimore, MD 21202

 

Incomplete submission will not receive consideration.

 

TTY  Users: call via Maryland Relay

We thank our Veterans for their service to our country, and encourage them to apply.

As an equal opportunity employer Maryland is committed to recruiting, retaining and promoting employees who are reflective of the State’s diversity.




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