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CF Compliance Consulting Group LLC Senior Counsel - Health in Dallas, Texas

[CF Compliance Consulting Group is seeking a Senior Counsel - Health. [This role is responsible for providing legal and compliance support and oversight of health insurance compliance for a financial services client of CF CCG that is based in Dallas, Texas (the Client). This role will involve secondment to the Client and reporting to Clients Assistant General Counsel, Compliance and to senior management. The Client is an Insurance Marketing Organization (IMO) and the role will include services to the Client and its subsidiaries, including subsidiaries that distribute health insurance, and related financial services businesses. This role will coordinate and work with outside counsel at Carlton Fields.

[Primary Responsibilities ]{arial",sans-serif"=""}]{arial",sans-serif"=""}]{arial",sans-serif"=""}

  • Analyze evolving compliance and regulatory landscapes affecting health insurance business, and provide a framework and counsel for compliance with such rules and regulations to business units.
  • Develop training programs for compliance officers and agents; establish benchmarks for impact assessment; develop reporting capabilities; work with the AGC to develop KPIs.
  • Provide legal counsel on health carrier products and insurance-related matters, including regulatory affairs.
  • Facilitate drafting and submission of regulatory documents as required.
  • Assist in identifying, managing, disclosing, and advising regarding risks related to the health segment
  • Investigate identified compliance matters, including corrective action and mitigation.
  • Participate in internal and external exams and audits, including audits by federal, state and private payors; resolve compliance issues and respond to legal or administrative inquiries related to compliance issues or audits/exams.
  • Engage in incident response activities as necessary, collaborating with Compliance and Legal teams.

[Required Competencies ]{arial",sans-serif"=""}

  • Ability to provide thoughtful analysis of complex legal and regulatory issues and provide actionable advice in a fast-paced environment.
  • Collaborative approach with Compliance and Legal teams to ensure compliance with laws and regulations.
  • Proactive in staying abreast of emerging compliance issues and their business implications.

[Education and Experience ]{arial",sans-serif"=""}

8-12 years as a practicing Attorney

In-house legal experience at a health insurance carrier is required

Law firm experience advising health insurance companies is helpful

[Expertise in navigating Stark, Anti-Ki ]{arial",sans-serif"=""}

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