New 
Product Contract Compliance Specialist
 Spectraforce Technologies | |
 United States, North Carolina, Raleigh | |
| 500 West Peace Street (Show on map) | |
 Jan 15, 2026 | |
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Job Title:
Product Contract Compliance Specialist Location: Remote Duration: 6 months Assignment Description: Responsible for supporting the development and maintenance of contract language and materials (e.g. benefit booklets, schedule of benefits, endorsements) to support custom options and non-standard benefits for new and renewing large groups and/or project deliverables for Individual <65 and Group products. Works under moderate supervision to ensure all materials are developed accurately, timely and in compliance with legislative and regulatory requirements to support group specific requests and project/initiatives. Demonstrates a solid level of product and business knowledge in supporting business stakeholders to work cross functionally and meet Product Line Plan, Sales and Enterprise objectives. Essential functions: * The essential functions listed represent the major duties of this role, additional duties may be assigned. * Contract Language and Materials Development * Supports the development and maintenance of contract language and materials (e.g. benefit booklets, schedule of benefits, endorsements) to support custom options and non-standard benefits for new and renewing large groups and/or project deliverables for Individual <65 and Group products. * Supports the review and evaluation of business requirements to determine contract material impacts (e.g. number of forms, type of impact), forecast timelines and identify any issues. * Supports the translation of business requirements and mandated legislation into legally-compliant member contract language and materials. * Ensures compliance with all legislative, regulatory, and BCBSA Inter-Plan Program requirements in the health insurance market. * Supports the management of the product life-cycle by updating member and group materials with language changes for new programs, services and benefits. * Creates and provides finalized forms (static and variable) and schedule of benefits mock-ups and redlines to contract fulfillment systems (e.g. Contract Automation). * Supports auditing and/or system testing of contract materials. * Tracks and monitors progress on contract materials to ensure project or sales objectives are delivered on time, adhere to high quality standards and meet customer expectations. * Communicates and collaborates with cross-enterprise business areas (e.g. Product Development, Legal, Pharmacy Programs) as appropriate throughout the contract development and review processes to ensure all compliance, regulatory and project deadlines are met. * Builds and maintains effective working relationships and consultation with Sales, Product and Rate Administration and Contract Automation to execute the creation and fulfillment of group specific contract materials. * Enterprise & Business Operational Support * Supports the organization, maintenance and data integrity of contract databases and libraries. * Coordinates and facilitates changes to member and group enrollment forms, including the Group Administrative Guide (GGA), with business stakeholders. * Identifies any potential issues or discrepancies, provides feedback and works to implement solutions with peers, Legal, Sales and Product Management. * Coordinates and facilitates member and groups mailings, including the development of complex forms mapping and pre/post address validation. * Supports mailbox requests from internal business partners such as Legal, Sales, Grievance & Appeals, and Critical Inquiries. * Supports timely retrieval & dissemination of contract language and materials to meet internal & external business needs such as regulatory examinations, audits and investigations. * Product Contract Advisor * Develops and maintains in depth knowledge of Individual <65 and group products, including applicable state and federal legislative and regulatory requirements. * Provides guidance to peers and business partners for any contract related questions and/or issues. * Supports contract and product training for employees or contractors in the area. * Provides consultative input on contract materials for sales partners and external group business administrators in support of group set-up and renewal. * Supports the development and maintenance of departmental policies and procedures (e.g. SOPs). * Identifies and implements process improvements to enhance overall process efficiency and effectiveness. * Product Filings * Prepares contract materials for product filings and coordinates with Legal and Actuarial to ensure filings are submitted accurately and timely to the Office of Insurance Regulation (OIR) and other applicable regulatory bodies. * Provides guidance to the processes and business partners involved in the development and filing of contract materials. * Supports key stakeholders in resolving any issues relevant to securing filing approvals. Job requirements: * Strong written and oral English communication skills. * Experience multi-tasking and working independently * Strong analytical, organizational, and time-management skills. * Demonstrated ability to maintain confidentiality and professionalism with all staff levels * Working knowledge of call center software * Strong PC skills, to include Microsoft Office and Internet navigation skills l. * Experience working with and improving customer experience. * Knowledge of product or client compliance procedures Additional Required Qualifications: * 2 years or more experience with Florida Blue products in the Individual <65 and Group segments * Project management skills with experience supporting projects * Solid understanding of the health and/or ancillary insurance industry, specifically state and federal legislative and regulatory impacts * Experience working in a dynamic team environment where shifting priorities and high work volumes are common place * Ability to communicate effectively with internal and external business partners * Experience with defining and resolving issues utilizing strong problem solving skills * Knowledge of PC office software such as SharePoint and MS Office applications (e.g. Word, Excel and PowerPoint) * Ability to support sizing and integration planning with stakeholders * Flexible with the ability to coordinate and handle multiple deliverables/ priorities within strict deadlines and timelines * Strong, positive relationships established with Legal and Sales business partners * Strong attention to detail, specifically as it relates to written communication in the areas of grammar, spelling, proof reading and punctuation Additional Preferred Qualifications: * Knowledge of medical terminology, benefit coding, and clinical procedures * Experience with custom options and non-standard benefits for large groups * Working knowledge of RBMS and Contract Automation systems * Experience with Siebel Sales applications Required Work Experience 3-5 years of related work experience or equivalent combination of transferable experience and education Required Education High school diploma or GED | |