Assistant General Counsel – General Regulatory
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Job Description
Provide legal counsel on healthcare regulatory matters across the enterprise at GuideWell. Requires advanced expertise in healthcare law and compliance with 10+ years of experience.
Responsibilities:
- Monitor and interpret federal and state healthcare laws, regulations, regulatory guidance, and enforcement activities affecting GuideWell, its subsidiaries, and business operations.
- Advise business units, operational leaders, and compliance functions on regulatory requirements, compliance obligations, and implementation strategies across the enterprise.
- Develop, review, and update regulatory compliance policies, procedures, and guidance documents; ensure organizational policies reflect current regulatory requirements and best practices.
- Provide legal analysis and counsel on healthcare regulatory matters including health insurance regulations, and managed care operations.
- Conduct regulatory risk assessments for new products, services, business arrangements, and operational changes; advise on regulatory implications and mitigation strategies.
- Coordinate with external counsel and consultants on complex regulatory matters; manage outside counsel relationships within budgetary parameters.
- Support compliance program development and implementation to address federal and state regulatory requirements and mitigate regulatory risk.
- Advise on regulatory aspects of contracts, partnerships, service agreements, and business transactions involving healthcare providers, vendors, and business partners.
- Provide legal research, analysis, and written opinions on regulatory questions and emerging regulatory issues affecting the organization.
- Prepare regulatory analysis and summary documents for Board committees, executive leadership, and business stakeholders on matters such as regulatory enforcement trends, legislative developments, and compliance priorities.
- Participate in regulatory examinations, requests for information, and inquiries from state and federal regulators; coordinate appropriate organizational response.
- Monitor healthcare industry regulatory trends, legislative developments, and enforcement priorities at federal and state levels; advise leadership on implications for organizational strategy and operations.
- May assume additional legal responsibilities and special projects as needed to support organizational objectives and the broader legal department.
Requirements:
- Juris Doctorate degree from an accredited law school with a strong academic record and 10+ years of professional legal experience.
- Admission to at least one state bar. If bar admission is in a state other than Florida, then the ability to be certified in Florida as Authorized House Counsel.
- Comprehensive knowledge of federal and state healthcare regulatory framework including HIPAA, Health Insurance Portability and Accountability Act regulations, CMS rules and guidance, managed care regulations, and health plan operations requirements.
- Strong knowledge of state insurance laws and regulations governing health insurers, health plans, and managed care entities across multiple states.
- Demonstrated expertise in healthcare provider regulations, network adequacy standards, credentialing and peer review requirements, and other provider-related regulatory matters.
- Advanced knowledge of federal healthcare compliance programs and requirements including anti-kickback statutes, Stark law, fraud and abuse regulations, and False Claims Act implications.
- Demonstrated experience providing regulatory advice and counsel to healthcare organizations or business units on compliance and operational matters.
- Proven ability to analyze complex regulatory requirements and develop practical compliance solutions aligned with business objectives.
- Strong knowledge of healthcare industry operations, business models, and regulatory challenges affecting insurers, health plans, and integrated delivery systems.
- Excellent written and verbal communication skills with the ability to translate complex regulatory concepts for non-attorney business audiences.
Benefits:
- Medical, dental, vision, life and global travel health insurance;
- Income protection benefits: life insurance, short- and long-term disability programs;
- Leave programs to support personal circumstances;
- Retirement Savings Plan including employer match;
- Paid time off, volunteer time off, 10 holidays and 2 well-being days;
- Additional voluntary benefits available;
- A comprehensive wellness program
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