Counsel, Regulatory Compliance

Exemption Status:

United States of America (Exempt)

$124,353 - $174,096 - $223,838

“Pay scale information is not necessarily reflective of actual compensation that may be earned, nor a promise of any specific pay for any selected candidate or employee, which is always dependent on actual experience, education, qualifications, and other factors.  A full review of our comprehensive pay and benefits will be discussed at the offer stage with the selected candidate.”

This position is not eligible for Sponsorship.

MedImpact Healthcare Systems, Inc. is looking for extraordinary people to join our team!

Why join MedImpact? Because our success is dependent on you; innovative professionals with top notch skills who thrive on opportunity, high performance, and teamwork. We look for individuals who want to work on a team that cares about making a difference in the value of healthcare.

At MedImpact, we deliver leading edge pharmaceutical and technology related solutions that dramatically improve the value of health care. We provide superior outcomes to those we serve through innovative products, systems, and services that provide transparency and promote choice in decision making. Our vision is to set the standard in providing solutions that optimize satisfaction, service, cost, and quality in the healthcare industry. We are the premier Pharmacy Benefits Management solution!

Job Description

Summary

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.

Essential Duties and 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.

Supervisory Responsibilities         

No supervisory responsibilities.

Client Responsibilities

This is an internal and external client facing position that requires excellent customer service skills and interpersonal communication skills (listening/verbal/written). One must be able to; manage difficult or emotional client situations; Respond promptly to client needs; Solicit client feedback to improve service; Respond to requests for service and assistance from clients; Meet commitments to clients.

Qualifications

To perform this job successfully, an individual must be able to perform each essential duty satisfactorily. The requirements listed below are representative of the knowledge, skill, and/or ability required. Reasonable accommodation may be made to enable individuals with disabilities to perform the essential functions.

Education and/or Experience

BS/BA and 5+ years’ experience or equivalent combination of education and experience, and 2 years' of SME in respective areas

Computer Skills

Strong PC skills in Microsoft Office Suite, MS Outlook. Familiar with relational databases and industry specific software.

Certificates, Licenses, Registrations

Juris Doctorate required.

Other Skills and Abilities           

• 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

Reasoning Ability                                            

• 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.

Mathematical Skills   

• 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.

Language Skills

• 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.

Competencies To perform the job successfully, an individual should demonstrate the following competencies:

• 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

Physical Demands The physical demands described here are representative of those that must be met by an employee to successfully perform the essential functions of this job. Reasonable accommodations may be made to enable individuals with disabilities to perform the essential functions.

While performing the duties of this Job, the employee is regularly required to sit; use hands to manipulate a mouse, use a computer, speak or hear. The employee is occasionally required to stand; walk and reach with hands and arms. The employee must occasionally lift and/or move up to 10 pounds. Specific vision abilities required by this job include close vision, distance vision, depth perception and ability to adjust focus.

Work Environment The work environment characteristics described here are representative of those an employee encounters while performing the essential functions of this job. Reasonable accommodations may be made to enable individuals with disabilities to perform the essential functions. The noise level in the work environment is usually quiet. The position will be remote and based from San Diego with some flexibility for occasional in office work.

Working Hours This is an exempt level position requiring an employee to work the hours needed to get the job done. Therefore one must have the flexibility to work beyond traditional hours and be able to work nights, weekends or on holidays as required. This may be changed from time to time to meet the needs of the business. Typical core business hours are Monday through Friday from 8:00am to 5:00pm.

Travel This position may require domestic travel and attendance maybe required at various local conferences and meetings.

The Perks:

• Medical / Dental / Vision / Wellness Programs

• Paid Time Off / Company Paid Holidays

• Incentive Compensation

• 401K with Company match

• Life and Disability Insurance

• Tuition Reimbursement

• Employee Referral Bonus

To explore all that MedImpact has to offer, and the greatness you can bring to our teams, please submit your resume to www.medimpact.com/careers

MedImpact, is a privately-held pharmacy benefit manager (PBM) headquartered in San Diego, California. Our solutions and services positively influence healthcare outcomes and expenditures, improving the position of our clients in the market. MedImpact offers high-value solutions to payers, providers and consumers of healthcare in the U.S. and foreign markets.

Equal Opportunity Employer, Male/Female/Disabilities/Veterans

OSHA/ADA:

To perform this job successfully, the successful candidate must be able to perform each essential duty satisfactorily. The requirements listed are representative of the knowledge, skill, and/or ability required.
Reasonable accommodations may be made to enable individuals with disabilities to perform the essential functions.

Disclaimer:

The above statements are intended to describe the general nature and level of work being performed by people assigned to this classification. They are not intended to be construed as an exhaustive list of all responsibilities, duties, and skills required of personnel so classified.