The mission of the Department of Insurance is to enforce the insurance laws and regulations of the state impartially, honestly and expeditiously.
The Louisiana Department of Insurance is seeking an Insurance Specialist 4 to join the Office of Health, Life & Annuity/Pharmacy Benefit Management (PBM) Enforcement Division. This position performs complex investigations and compliance reviews of pharmacy benefit managers (PBMs), analyzes technical and financial information, and supports regulatory enforcement activities to ensure compliance with applicable state and federal laws and regulations.
The ideal candidate possesses the following competencies:
Core Competencies:
- Developing Plans: The ability to create structured strategies and plans that support the achievement of defined goals and objectives.
- Making Accurate Judgments: The ability to assess options, weigh risks, and make sound decisions using available information and logical reasoning.
- Managing Stakeholders: The ability to identify key stakeholders, manage relationships, and align interests to move work forward.
Six years of full-time work experience in any field plus three years of experience in insurance, administrative services, investigations, or law enforcement; OR
A bachelor's degree plus three years of experience in insurance, administrative services, investigations, or law enforcement; OR
An advanced degree plus two years of experience in insurance, administrative services, investigations, or law enforcement.
EXPERIENCE SUBSTITUTION:
Every 30 semester hours earned from an accredited college or university will be credited as one year of experience towards the six years of full-time work experience in any field. The maximum substitution allowed is 120 semester hours which substitutes for a maximum of four years of experience in any field.The official job specifications for this role, as defined by the State Civil Service, can be found here.
Job Duties:
As an Insurance Specialist 4 in the Office of Health, Life & Annuity/PBM Enforcement Division, you will/may:
- Conduct complex investigations and compliance reviews of pharmacy benefit managers (PBMs) to ensure compliance with state and federal laws and regulations.
- Review and analyze technical, financial, and operational documentation, reports, and other information submitted by PBMs and related entities.
- Meet with company officials and other stakeholders to gather information and evaluate pharmacy benefit management practices.
- Analyze investigative findings and market information to identify potential violations and compliance concerns.
- Prepare investigative reports and supporting documentation for regulatory and enforcement actions.
- Draft correspondence, notices, and other documents related to enforcement activities, and participate in hearings and related proceedings.
- Maintain current knowledge of state and federal laws, regulations, and regulatory developments affecting pharmacy benefit management.
- Perform other duties related to pharmacy benefit management oversight as assigned.
Position-Specific Details:
Division/Location: Office of Health, Life & Annuity/Pharmacy Benefit Management (PBM) Enforcement Division
Appointment Type: Promotional or Probational
Career Progression: This position will be filled as an Insurance Specialist 4
Compensation: The salary will be determined based on qualifications and experience within the established pay range.How To Apply:
NO CIVIL SERVICE exam is required to be considered for this vacancy.
To apply for this vacancy, click on the “Apply” link above and complete an electronic application, which can be used for this vacancy as well as future job opportunities. Applicants are responsible for checking the status of their application to determine where they are in the recruitment process. Further status message information is located under the Information section of the Current Job Opportunities page.
*Information to support your eligibility for the position must be included in the application (i.e., relevant, detailed experience/education). Resumes will not be accepted in lieu of completed education and experience sections. Applications may be rejected if incomplete.
Contact Information:
For further information about this vacancy, contact:
Dr. Phillip Donagriche
Human Resources Division
Louisiana Department of Insurance
P.O. Box 94214
Baton Rouge, LA 70804
Phillip.Donagriche@ldi.la.gov
Louisiana is a State As a Model Employer (SAME) that supports the recruitment, hiring, and retention of individuals with disabilities.
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