Description:
What you'll doIn a few words…
A Healthcare Management Company is igniting a revolution in healthcare. We built our company on the belief that with smarter technology we are redefining pharmacy benefits, but this is just the beginning…
The Legal & Compliance department ensures our business operations and processes are compliant with all state and federal requirements. They keep A Healthcare Management Company updated on all regulatory and legislative developments to mitigate the impact on the services we offer! They're also the team we go to for channeling services from our external legal counsel and working on matters related to tax, audits, managing codes of conduct as well as corporate, and healthcare law.
As Counsel for Regulatory Affairs, you will be responsible for the review, analysis and interpretation of legislation and regulatory sources, assessing the applicability and impact to A Healthcare Management Company, overseeing the cross-functional implementation of regulatory and legal requirements, working closely with operational business units to ensure understanding of these requirements, and determining any risks that may affect A Healthcare Management Company.
The fundamentals for the job…
- Monitoring and tracking of state and federal legislative and regulatory measures impacting A Healthcare Management Company,
- Review, analyze and assess changes in state and federal laws and regulations, determining any risks or impact to A Healthcare Management Company, and coordinating with business areas to capture and document operational/system impacts and proposed solutions.
- Oversee the cross-functional implementation of legal and regulatory requirements, ensuring understanding of these requirements across business units and A Healthcare Management Company.
- Provide counsel on proposed legislation and regulations to impacted business units and clients.
- Assess regulatory and legal risks of any corporate initiatives and products.
- Draft responses to inquiries and consults presented by the business or clients regarding legal and regulatory requirements including but not limited to, federal legislation, Medicaid and Medicare legislation and guidance, state legislation applicable to the healthcare industry, or other state statutes or regulations where A Healthcare Management Company may be engaged in business.
- Collaborate with our Government & Industry Partnerships team on advocacy strategies for engaging with regulators and policymakers, preparing assessments of state and federal policy and legislative measures, providing amendments to proposed legislation impacting A Healthcare Management Company, and drafting position papers requested by State Legislature or others.
- Attend regulatory meetings (bi-weekly or as necessary) and coordinate with internal stakeholders on regulatory and legislative issues as they arise.
- When needed, lead stakeholder and industry related activities to coordinate initiatives related to legislation or matters impacting A Healthcare Management Company and/or the industry.
- Coordinate with clients' internal legal counsel as needed for regulatory matters.
- Be up to date on applicable regulatory and legal requirements and be an educational source of knowledge and legal wisdom whenever needed.
What we expect of you
The bold requirements…- Juris Doctor Degree from an accredited law school and licensed to practice law in at least one (1) state.
- 8+ years of experience with regulatory affairs, contractual or corporate compliance.
- Experience in healthcare industry, including managed care organizations, PBMs.
- Experience managing research and proficiency in regulatory sites and legal research systems (i.e. CMS, Westlaw, etc.).
- Excellent oral and written communication skills.
- We are proud to offer a flexible hybrid work model which will require certain on-site workdays (Puerto Rico Location Only)
Nice to haves…
- Experience with Medicare Operations and/or Part-D regulations.
- Be versed in California healthcare and industry regulatory and legal requirements.
- Experience in project planning and implementation.
Physical requirements…
- Must be able to access and navigate each department at the organization's facilities.
- Sedentary work that primarily involves sitting/standing.