NETWORK ADEQUACY ANALYST I-III (MIA Officer II - MIA Analyst II)

at  State of Maryland

INTRODUCTION

The Maryland Insurance Administration (MIA) is an independent State agency that regulates Maryland’s $46 billion insurance industry and protects consumers by monitoring and enforcing insurers’ and insurance professionals’ compliance with State law. 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.

• This is a Special Appointment position that serves at the pleasure of the appointing authority.

DESIRED OR PREFERRED QUALIFICATIONS

• Strong investigative skills
• Proficiency in qualitative and quantitative analysis

POSITION DUTIES

The MIA is recruiting for a Network Adequacy Analyst I, II, or III in the Life and Health Division. This position performs analysis of network access plans and waiver requests submitted by health insurers, HMOs, nonprofit health services plans, and dental plans, to ensure provider panel adequacy and compliance with Maryland laws and regulations. The analysis includes evaluating the methodologies used by companies to measure network adequacy and determining whether specific quantitative metrics for network adequacy standards have been met with sufficient documentation and justification. This position corresponds with companies to request additional information concerning network access plans and/or issues, deficiencies, or violations of Maryland statutes or regulations. The incumbent drafts, reviews, and edits plan analysis and waiver related reports and makes recommendations for corrective actions. This position may also assist with market conduct examinations and investigations.

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.

• This is a Special Appointment position that serves at the pleasure of the appointing authority