Regulatory Compliance Attorney Duties: Serve as expert on regulations and compliance for all commercial health insurance and ancillary lines of business. Provide legal advice and perform contract reviews. Provide consultation on compliance matters to facilitate decision-making at all levels of management, which includes identifying and communicating trends in legislative activity to allow management to make decisions on a proactive basis. Research, analyze, report, and provide recommendations for issues and new processes related to compliance and regulatory changes for Centers of Medicare & Medicaid Services (CMS), various State Department of Insurance agencies, and internal inquiries related to complaints. Collaborate with other business areas to compile needed information and ensure timely filing of various state required forms and regulatory licenses. Lead and/or participate on project teams and coordinate interdepartmental resources to successfully implement major new legislative changes, such as health care reform. Serve as legal advisor to Grievance/Appeal Committee. File required regulatory reports with various Federal and State agencies. Review marketing materials for legal compliance and file materials for approval, if needed. Act as a resource to staff in the Regulatory Compliance section and assist the Managing Regulatory Compliance Attorney in directing the work of staff in the Regulatory Compliance section of the Legal Department.
Qualifications: Bachelor's Degree in related field or equivalent post high school and/or related work experience. Law degree from an accredited law school. 1+ years of legal experience. Practical experience advising business clients on navigating complex regulatory issues. Experience working in an environment that serves our Nation's military, veterans, Guard and Reserves and Medicare beneficiaries. Have a passion for and/or interest in health care/insurance law and/or regulatory compliance issues. Excel at working in a fast-paced environment and thrive on challenges. Love a dynamic industry that is consistently changing and evolving. In-depth knowledge of various aspects of insurance, managed care, pharmacy, Medicare Supplement, and health care compliance. Continuous performance feedback. Preferred Qualifications: 3+ years of legal experience. Knowledge of Wisconsin insurance regulations as well as the Affordable Care Act. Experience in health care/insurance law
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