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Regulatory Compliance Attorney The candidate will serve as expert on regulations and compliance for all commercial health insurance and ancillary lines of business. Conduct privacy investigations and reviews in accordance with HIPAA and other applicable Federal and State laws. 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. Law degree from an accredited law school is required. Should have 1+ years of legal experience. Should preferably have 3+ years of related experience. Experience in health care/insurance law is preferred. Knowledge of Wisconsin insurance regulations as well as the Affordable Care Act is preferred. Knowledge of and experience in health care-related privacy issues is a plus. Should be admitted, active, and in good standing with the State Bar of Wisconsin (or with another state bar and registered, or eligible to register, as in-house counsel with the State Bar of Wisconsin).
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