Lead Insurance Counsel - Unclassified

State of Nevada•Carson City, NV

21h•Onsite

About The Position

The Public Employees’ Benefits Program (PEBP) Insurance Counsel provides legal guidance and advice on matters affecting state and federal compliance for the PEBP, which provides group health insurance and basic life insurance to active employees and retirees. This position ensures the program’s legal integrity and compliance with federal law, Nevada statutes and regulations, and public-sector administrative requirements. The Counsel supports executive leadership and the Board by providing authoritative guidance on regulatory obligations, governance, procurement, appeals, and plan administration. The role collaborates closely with the Deputy Attorney General to ensure all actions align with state law, statewide policy, and public-sector standards for accountability, transparency, and ethical conduct.

Requirements

Juris Doctor (J.D.) degree from an accredited law school.
Active membership in good standing with the State Bar of Nevada, or eligibility for reciprocity with the ability to obtain Nevada licensure within 6 months of hire.
Minimum 3 years of experience practicing law.
Foundational knowledge of health, administrative, insurance, or related area of law
Experience advising clients on compliance, appeals, contract oversight, or regulatory interpretation
In-depth knowledge of federal and state laws applicable to public-sector benefit plans like PEBP
Understanding of COBRA, ACA, IRS, HIPAA and PEBP statutes and code.
Ability to analyze complex regulatory and public-sector compliance scenarios
Skillful in providing clear, actionable legal guidance to government leadership, the Board, and staff
Proven ability to draft precise legal documents, including plan documents, notices, contracts, memoranda.
Excellent verbal and written communication; comfortable presenting to boards, executives, and vendors.
Effective relationship-builder; able to coordinate across internal and with external partners.
High integrity and judgment aligned with public-sector ethics standards
Ability to manage confidential and sensitive information discreetly.
Strong organizational skills with ability to manage multiple priorities and projects.
Demonstrated ability to prioritize under tight deadlines.

Nice To Haves

Experience with legal issues involving group health insurance, self-insured plans, fully insured plans, COBRA, HIPAA, Affordable Care Act, and state insurance laws
Prior work with public agencies, state-administered benefit programs, or government regulatory bodies
Familiarity with Nevada public-sector requirements, including procurement rules, administrative hearings, open meeting laws, and public records obligations

Responsibilities

Ensure PEBP operates in compliance with Nevada Revised Statutes (NRS), Nevada Administrative Code (NAC), and statewide policies governing public agencies
Interpret federal and state mandates affecting PEBP and advise leadership on necessary operational or policy changes
Support compliance with reporting, public records laws, open meeting requirements, legislative reviews, audits, and statewide oversight processes
Provide legal guidance related to public accountability standards, ethical obligations, and transparency requirements expected of state programs
Advise on federal COBRA and Nevada continuation coverage requirements
Develop and maintain COBRA policies, notices, forms, and procedures
Address complex COBRA-eligibility scenarios, including cases involving multi-state employment, intergovernmental transitions, and variable-qualified beneficiaries.
Oversee participant and provider appeals processes in accordance with Nevada state law and any applicable plan or contract provisions
Review appeals determinations and support state administrative hearings and coordinate as needed with the Office of the Attorney General with such disputes
Coordinate with third-party administrators and external counsel as needed
Review determinations to ensure compliance with statutory obligations, plan rules, and fair-hearing standards
Present legal updates, compliance risks, and strategic recommendations to executive leadership
Present to Board on behalf of the Executive Officer on legal or compliance matters
Prepare legal analyses addressing policy changes or statutory amendments risks
Interpret statutory and regulatory changes impacting the plan and provide recommendations to mitigate or address compliance risks
Provide guidance to the Executive Officer on governance practices expected of state authorities and the Board
Ensure plan design updates comply with applicable state and federal laws and public-sector requirements for benefit administration
Draft and maintain Plan Documents, Summary Plan Descriptions (SPDs), policies, and amendments reflecting statutory mandates and administrative rules
Draft, review, and negotiate agreements with vendors, TPAs, PBMs, ERIs (stop-loss carriers), consultants, and others as requested by the Executive Officer
Ensure contract language aligns with Nevada procurement statutes, state contracting standards and regulatory compliance
Strengthen protections in contracts for data security, performance guarantees, indemnification, and HIPAA/BIPA compliance
Track changes in federal and state laws affecting PEBP
Recommend policy or operational adjustments to maintain compliance with DOL, IRS, HHS, CMS HHS, NV Division of Insurance, and state administrative requirements.
Proactively adapt policies and materials to maintain compliance with DOL, IRS, HHS, and Nevada insurance regulations.
Support legislative analysis, regulatory filings, audits, and compliance reviews relevant to PEBP.