Corporate & Regulatory Counsel- Health Insurance Compliance

About the role

Wellfleet, a Berkshire Hathaway company, seeks an experienced Corporate & Regulatory Counsel to support the Wellfleet legal team. The ideal candidate will have a strong background in insurance law, particularly in health care regulatory compliance, clinical operations support, and mental health parity compliance.

Responsibilities

• Provide subject matter expertise on Mental Health Parity and Addiction Equity Act (MHPAEA) compliance, including nonquantitative treatment limitations (NQTLs), network design and adequacy, prior authorization and utilization review, reimbursement policies and standards
• Collaborate cross-functionally with internal teams to ensure MHPAEA considerations are integrated into product design, clinical policies and vendor oversight
• Advises on compliance with state and federal health care laws and regulations
• Advise on delegation arrangements with third parties, including TPAs, PBMs, behavioral health vendors and other delegated entities
• Collaborate cross-functionally with internal teams to support delegated entity oversight programs, including compliance monitoring, remediation, and regulatory reporting obligations
• Interpret new and evolving regulatory guidance and translate it into actionable recommendations for business and clinical teams
• Support regulatory exams, audits and inquiries from state departments of insurance and other regulatory agencies
• Support legally compliant implementation of clinical programs, quality initiatives and utilization controls
• Exercise strong business acumen and analyze legal issues from a business perspective
• Work closely with cross-functional team members and business leaders to review legal issues and implications of potential business decisions and initiatives
• Work with cross-functional team members to support delegated entity oversight programs, including compliance monitoring, remediation, and regulatory reporting obligations
• Manage several varied tasks and assignments efficiently and effectively to meet deadlines with high urgency
• May manage staff, and as applicable, conduct 1:1 weekly (or bi-weekly) “check-ins” with direct reports to establish expectations and ensure accountability regarding priorities and goals
• Establish and maintain a supportive learning environment by ensuring continuous development, training, and growth
• Coach and mentor team members by identifying areas of improvement by providing timely and constructive feedback
• Gives direction to support team members and drives success
• Perform other duties as assigned

Requirements

• J.D. from an accredited law school and admitted to practice law and in good standing with at least one state bar
• 7+ years of relevant insurance law experience, preferably within an in-house legal/compliance department
• Demonstrate a strong understanding of applicable insurance laws and regulations
• Experience working on cross-functional teams and tackling a broad range of issues in a fast paced and rapidly scaling environment
• Excellent legal research skills and proven ability to articulate and quickly deliver information to business stakeholders
• Capable of efficiently managing multiple tasks and competing priorities in a fast-paced environment
• Excellent organizational skills, including thorough and complete follow-up to all time sensitive items
• Strong verbal, written communication, presentation and negotiation skills
• Outstanding attention to detail with the ability to understand complex problems, identify root causes and effectively problem-solve
• Excellent analytical skills, with the ability to effectively identify, communicate, and address potential issues
• Works effectively both independently and as part of a team

Qualifications

• Strong understanding of applicable insurance laws and regulations
• Experience working on cross-functional teams and tackling a broad range of issues in a fast paced and rapidly scaling environment
• Excellent legal research skills and proven ability to articulate and quickly deliver information to business stakeholders
• Capable of efficiently managing multiple tasks and competing priorities in a fast-paced environment
• Excellent organizational skills, including thorough and complete follow-up to all time sensitive items
• Strong verbal, written communication, presentation and negotiation skills
• Outstanding attention to detail with the ability to understand complex problems, identify root causes and effectively problem-solve
• Excellent analytical skills, with the ability to effectively identify, communicate, and address potential issues
• Works effectively both independently and as part of a team

Skills

• Strong understanding of applicable insurance laws and regulations
• Experience working on cross-functional teams and tackling a broad range of issues in a fast paced and rapidly scaling environment
• Excellent legal research skills and proven ability to articulate and quickly deliver information to business stakeholders
• Capable of efficiently managing multiple tasks and competing priorities in a fast-paced environment
• Excellent organizational skills, including thorough and complete follow-up to all time sensitive items
• Strong verbal, written communication, presentation and negotiation skills
• Outstanding attention to detail with the ability to understand complex problems, identify root causes and effectively problem-solve
• Excellent analytical skills, with the ability to effectively identify, communicate, and address potential issues
• Works effectively both independently and as part of a team

Benefits

We offer a competitive compensation package and comprehensive benefits package including medical, vision and dental insurance options, life and accident insurance, 401(k), and short-term and long-term disability insurance. For a more detailed overview, visit our careers website at: wellfleetinsurance.com/about/careers.

Pay

The annual gross base salary range is $125,000 to $175,000. This range anticipates the low and high end of the salary for this position. Actual salaries will vary and are based on factors such as a candidate's qualifications, skills and competencies.

Schedule

Full-time position.