Corporate & Regulatory Counsel- Health Insurance Compliance

Wellfleet, a Berkshire Hathaway company, delivers customer-centric accident and health insurance, with quality service and uncompromising ethics. Wellfleet works to protect people against risk throughout every stage of life – from grade school to college to the workplace.

Founded in 1993 as Consolidated Health Plans (CHP), Wellfleet, headquartered in Springfield, Mass., is one of the nation’s leading providers of health and accident insurance products to the higher education market.

Wellfleet, a Berkshire Hathaway Company, seeks an experienced Corporate & Regulatory Counsel to support the Wellfleet legal team.

The Corporate & Regulatory Counsel is responsible for supporting a nationwide accident and health insurance carrier by handling a wide range of corporate and insurance regulatory matters, with a focus on state and federal health care regulatory compliance, clinical operations support, delegated entity oversight, and mental health parity compliance. This position is well-suited for an attorney with deep health care regulatory experience who is comfortable operating at the intersection of law, clinical and health plan operations.

In this role, you will…

• 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
• Advise 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
• Act with a high level of personal integrity, professionalism, intellectual curiosity and willingness to grow
• 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.

We are looking for candidates with…

• 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
• Ability to motivate team members and provide direction to drive success
• Works effectively both independently and as part of a team.

Why Wellfleet?

Here at Wellfleet, we foster a culture of growth that enables engaged and high-performing professionals to be empowered to deliver our mission and vision.

Our employees are a team devoted to providing customer service that exceeds expectations of our members and clients. Successful team members continually look for ways to improve product delivery and value.

Wellfleet offers a competitive compensation package and comprehensive benefits package including life, health and dental, vision, 401K retirement plan, short- and long-term disability coverage, flexible/dependent care spending account, tuition reimbursement, and business casual dress.

Are you interested in exploring a career at Wellfleet? Explore our open positions.

General:

Wellfleet is part of the MedPro Group family. As such, all Wellfleet team members are employees of MedPro Group Inc. We are an Equal Opportunity Employer. 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.  Salary is one component of Wellfleet’s total compensation and benefits package, which includes 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. #LI-KS1 #LI-Remote

• $125,000 - $175,000