Compliance Director – Policyholder Investigations

Position Summary

The Compliance Director is responsible for leading and managing the team that investigates insurance policyholder and Department of Insurance complaints, ensuring all responses meet regulatory, contractual, and internal standards for quality, accuracy, and timeliness. This role requires a strategic leader who can motivate and develop team members, drive operational excellence, and foster cross-functional collaboration. The ideal candidate will have deep experience in life or health insurance, particularly in policyholder investigations and response processes.

Key Responsibilities

Leadership & Team Development

Inspire and lead a team of compliance analysts and investigators.

Foster a culture of accountability, continuous improvement, and professional growth.

Provide coaching, mentoring, and performance feedback to direct reports.

Operational Excellence

Ensure all complaint investigations and response letters meet service level agreements (SLAs) for quality and timeliness.

Monitor and report on team performance metrics.

Drive adherence to internal and regulatory quality standards.

Process Improvement

Identify inefficiencies and implement process enhancements to improve turnaround time and accuracy.

Develop and refine workflows, templates, and tools to support investigation and response activities.

Cross-Functional Collaboration

Partner with Legal, Claims, Customer Service, and other departments to ensure consistent and compliant handling of complaints.

Serve as a liaison between compliance and operational teams to align goals and resolve escalated issues.

Subject Matter Expertise

Maintain up-to-date knowledge of regulatory requirements related to life and health insurance.

Provide guidance on complex complaint cases and ensure appropriate resolution strategies.

Required Skills & Qualifications

Experience

Minimum 10–12 years in compliance, investigations, or regulatory affairs within the life or health insurance industry.

Includes minimum 5-7 years managerial and leadership experience

Proven experience managing teams and driving performance in a regulated environment.

Strong background in policyholder complaint investigations and response letter drafting.

Skills

Exceptional leadership and people management skills.

Strong analytical and problem-solving abilities.

Excellent written and verbal communication skills.

Ability to manage multiple priorities and meet deadlines.

Proficiency in compliance systems, case management tools, and Microsoft Office Suite.

Education

Bachelor’s degree in Business, Law, Healthcare Administration, or related field (Master’s or JD preferred).

Preferred

Experience with regulatory bodies such as state insurance departments.

Familiarity with complaint handling standards under NAIC guidelines.

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