What are the responsibilities and job description for the Legal Business Compliance Specialist position at Detego Health Benefits?
The Position
Title: Legal Business Compliance Specialist
Location: On-Site
Reports to: COO
Position Summary
The Legal Business Compliance Specialist plays a critical role in ensuring that Detego Health, the TPA (Third-Party Administrator) company, operates within the framework of applicable laws, regulations, and internal policies. This role involves managing legal compliance activities, mitigating risks, and providing guidance on regulatory matters to safeguard the organization's operations and reputation. The ideal candidate will have expertise in healthcare and business compliance, exceptional organizational skills, and a proactive approach to problem-solving.
_ Key Responsibilities_
Regulatory Compliance Monitor and interpret federal, state, and local regulations impacting the TPA industry, including HIPAA, ERISA, ACA, and other healthcare-related laws.
Ensure compliance with contractual obligations, state insurance regulations, and accreditation standards.
Develop and update compliance policies and procedures to reflect changes in legal and regulatory requirements.
Conduct regular compliance audits and assessments to identify gaps and implement corrective actions to external inquiries.
Participate in the Compliance Committee by contributing to the development, implementation, and evaluation of compliance strategies, policies, and procedures.
_ Legal Support_
o Provide legal research and analysis to support the company’s compliance efforts and business operations.
Draft, review, and maintain legal documentation, including contracts, service agreements, and regulatory filings, to ensure accuracy and compliance.
Collaborate with internal teams to address compliance-related legal matters and provide subject matter expertise.
Risk Management
Identify and assess potential legal and regulatory risks associated with the organization’s operations and develop strategies to mitigate those risks.
Investigate and resolve compliance issues, including incidents of non-compliance or regulatory violations, in coordination with legal counsel and compliance leadership.
Maintain comprehensive records of risk assessments, incident reports, and corrective actions.
Training and Communication
Develop and deliver compliance training programs to educate staff on legal obligations, regulatory changes, and ethical standards.
Act as a compliance resource, answering questions and providing guidance to internal departments and external stakeholders.
External Liaison
Serve as the point of contact for regulatory agencies, auditors, and external legal counsel during audits, investigations, or inquiries.
Coordinate responses to external inquiries, ensuring timely and accurate communication.
Reporting and Documentation
Prepare detailed compliance reports for executive leadership, summarizing findings, risks, and recommendations.
Maintain accurate and up-to-date documentation of compliance programs, legal matters, and regulatory changes.
_ Qualifications_
· Bachelor’s degree in legal studies, business administration, healthcare management, or a related field (Juris Doctor or paralegal certification is a plus).
· Minimum of 3-5 years of experience in legal compliance, preferably in the healthcare or TPA industry.
· Experience with healthcare regulations such as HIPAA, ACA, URAC, and ERISA is required.
_ Knowledge and Skills_
Strong knowledge of regulatory compliance frameworks, legal research, and contract management.
Exceptional organizational and analytical skills with attention to detail.
Proficiency in compliance management tools and legal research databases.
Excellent communication and interpersonal skills, with the ability to explain complex legal concepts clearly and concisely.
Strong ethical standards and the ability to handle sensitive and confidential information.
Behavioral Competency: Commitment to Company Culture and Continuous Improvement. Demonstrate alignment with the company’s core values and actively contribute to fostering a collaborative, inclusive, and high-performance culture. Embrace and apply EOS (Entrepreneurial Operating System) principles in daily tasks, team interactions, and decision-making processes to support organizational goals and drive operational efficiency. Exhibit a growth mindset by engaging in continuous learning and professional development, seeking opportunities to enhance skills and contribute to the company's success. Foster open communication and accountability, actively supporting teamwork, transparency, and a shared commitment to achieving company objectives.
Detego Health is an equal opportunity employer. All applicants will be considered for employment without attention to race, color, religion, sexual orientation, gender identity, national origin, veteran or disability status.
Job Type: Full-time
Pay: $65,000.00 - $75,000.00 per year
Schedule:
- 8 hour shift
- Monday to Friday
- No nights
- No weekends
Work Location: In person
Salary : $65,000 - $75,000