Counsel, Regulatory Compliance

MedImpact•San Diego, CA

2d•Remote

About The Position

Counsel, Regulatory Compliance is a key member of Regulatory Compliance and reports directly to the Corporate Compliance Officer, while maintaining an indirect reporting relationship with the General Counsel to ensure alignment with enterprise-wide legal strategy. This role is responsible for overseeing MedImpact's regulatory compliance activities, including continuous monitoring and implementation of state and federal laws, regulations, licensing requirements, sub-regulatory guidance, and emerging regulatory developments impacting commercial, Medicare, Medicaid, and Marketplace lines of business. The position provides legal interpretation and compliance guidance regarding enacted legislation, regulations, licensing requirements, market conduct examinations, regulatory audits, and corporate compliance assurance activities. The role supports organizational readiness for regulatory inquiries, examinations, and audits by government agencies, clients, accreditation organizations, and other oversight entities. Counsel serves as a strategic advisor to business leaders and compliance stakeholders, ensuring MedImpact maintains an effective compliance posture, strong governance framework, and alignment with evolving legal and regulatory requirements.

Requirements

BS/BA and 5+ years’ experience or equivalent combination of education and experience, and 2 years' of SME in respective areas
Strong PC skills in Microsoft Office Suite, MS Outlook.
Familiar with relational databases and industry specific software.
Juris Doctorate required.
Strong working knowledge of state and federal regulatory requirements, including licensing obligations and enacted legislation
Ability to interpret and communicate complex regulatory information in clear, accessible language
Excellent listening, analytical, and problem‑solving skills
Strong written and verbal communication skills tailored to diverse audiences
Ability to manage multiple priorities, meet deadlines, and work collaboratively across departments
Ability to define problems, collect data, establish facts, and draw valid conclusions.
Ability to interpret a variety of instructions furnished in written, oral, diagram, or schedule form.
Ability to add, subtract, multiply, and divide in all units of measure, using whole numbers, common fractions, and decimals.
Ability to compute rate, ratio, and percent and to draw and interpret bar graphs.
Ability to read and interpret documents such as safety rules, operating and maintenance instructions, and procedure manuals.
Ability to respond to common inquiries or complaints from customers, regulatory agencies, or members of the business community.
Ability to effectively present information and respond to questions from groups of managers, clients, customers, and the general public.
Ability to read, analyze, and interpret general business periodicals, professional journals, technical procedures, or governmental regulations.
Ability to read, analyze, and interpret the most complex documents.
Ability to effectively present information to top management, public groups, and/or boards of directors.

Nice To Haves

Composure
Decision Quality
Organizational Agility
Problem Solving
Customer Focus
Drive for Results
Peer Relations
Time Management
Dealing with Ambiguity
Learning on the Fly
Political Savvy

Responsibilities

Continuously track, prepare summaries, guidance documents and implementation recommendations related to enacted legislation, regulatory updates, licensing requirements, and sub‑regulatory guidance for assigned states; assess operational impact and communicate changes to internal stakeholders.
Perform special legal projects as assigned by the General Counsel, supporting enterprise‑wide legal and compliance priorities.
Develop clear, timely communications for clients regarding enacted legislation, regulatory changes, and licensing updates; lead cross‑functional review meetings
Provide leadership and oversight for regulatory examinations, market conduct reviews, audits, and governmental inquiries, including development of regulatory response strategies, review of examination materials and submissions, coordination with internal stakeholders and internal counsel, and interpretation of regulatory requirements, findings, and corrective action expectations.
Lead development and execution of strategic initiatives related to emerging regulatory trends and enacted legislation.
Serve as legal and compliance subject matter expert during examinations conducted by state insurance departments, Medicaid agencies, federal regulators, and other governmental entities.
Assist with the development and review of organization’s policies and procedures in relation to state or federal regulations.
Identifies needed policies and procedures in order to demonstrate compliance with applicable requirements and works with appropriate internal operational units to ensure creation and maintenance of needed documentation.
Ensure policies and procedures are revised to address regulatory changes.
Partner with Corporate Compliance Assurance and External Compliance Support teams to assess regulatory risks, identify compliance vulnerabilities, and support compliance monitoring and auditing activities.
Review compliance monitoring and audit results to evaluate potential regulatory exposure and recommend corrective actions, process enhancements, and risk mitigation strategies.
Interpret and advise on the application of state and federal healthcare laws, regulations, sub-regulatory guidance, and enforcement initiatives affecting MedImpact's operations, including Affordable Care Act Marketplace, Medicaid, and Medicare programs, while providing legal counsel on delegated responsibilities, compliance risks, and regulatory obligations.
Advise executive leadership on regulatory trends, enforcement priorities, and emerging legal risks affecting the PBM industry.
Support preparation of materials and presentations for the Corporate Compliance Committee and other governance bodies regarding significant regulatory developments, audit findings, examination outcomes, and compliance initiatives.
Collaborate with Legal, Compliance, Privacy, and operational business units to develop enterprise-wide compliance strategies and implementation plans.