Assistant Vice President, Compliance Counsel

Location

White Plains, NY | United States

Job description

The AVP-Compliance Counsel develops, monitors and reports on the corporate compliance program, for the Amalgamated Family of Companies, which consists of the Amalgamated Life Insurance Company and its affiliates, Amalgamated Employee Benefits Administrators, Inc., a third party benefits administrator, and Amalgamated Medical Care Management, Inc., a medical care management company. This role serves as an independent and objective body that reviews and evaluates compliance issues/concerns within the Family of Companies. The position ensures that management and employees of the Amalgamated Family of Companies are in compliance with the rules and regulations of all federal and state laws and regulations, and Company policies and procedures. The scope of compliance matters includes, but is not limited to, health law compliance (ACA, HIPAA, etc.), anti-fraud practices and procedures, marketing and sales practices, product development, claims, enterprise risk management, and privacy and IT security requirements. The Compliance Counsel shall act as the Company’s qualifying officer with the NYS Worker’s Compensation Board. The Compliance Counsel shall also oversee the Company’s Abandoned Property compliance program and reporting, including chairing the Abandoned Property committee.

• Develops, initiates, maintains and revises policies and procedures for the general operation of the Family of Companies’ compliance program, including responding to alleged violations, conducting investigations, and making recommendations in response to confirmed violations of any law, regulation or Company policy.
• Serves as the Director and lead investigator of the Company’s Special Investigations Unit for all insurance related fraud, waste and abuse claims, and maintains the Company’s Fraud Prevention Plan in accordance with state insurance laws.
• Provides compliance advice to senior leadership and management teams, including assessing compliance risks and identifying and interpreting applicable laws and regulations.
• Develops and periodically reviews and updates Standards of Conduct and other corporate policies.
• Collaborates with other departments to direct compliance issues to appropriate existing channels for investigation and resolution. Consults with the General Counsel as needed to resolve difficult legal compliance issues.
• Identifies potential areas of compliance vulnerability and risk; develops and implements corrective action plans for resolution of problematic issues, and provides general guidance on how to avoid or deal with similar situations in the future.
• Provides reports on a regular basis, and as directed and requested, to keep senior management informed of the operation and progress of compliance efforts.
• Works with the General Counsel in interacting with state and federal regulators with respect to examinations, complaints, inquiries, investigations, and appeals.
• Ensures the proper reporting of violations or potential violations to duly authorized enforcement agencies as appropriate and/or required.
• Institutes and maintains an effective compliance communication for the organization.
• Review, draft and negotiate the terms of contracts in a wide variety of practice areas, including service agreements, vendor contracts, settlement agreements, non-disclosure agreements, and business associate agreements.
• Oversee complex state regulatory filings, including interpretation of state extraterritorial jurisdiction requirements.
• Serve on the appeals committee for individual disability income insurance appeals.
• Provide legal guidance on federal and state privacy laws.
• Investigate potential privacy issues, prepare recommendations on reporting obligations, and make recommendations on operational improvements to enhance compliance in various business units.
• Research state and federal laws and regulations to respond to various requests for legal advice concerning the business of insurance and claims administration.
• Coordinate with the IT Department concerning business continuity and disaster response planning and training.
• Communicate with state insurance departments regarding investigations, complaints and regulatory compliance matters.
• Attend Board of Directors and Committee meetings to provide compliance reports, updates on compliance initiatives, and take meeting minutes.
• Work onsite in the White Plains headquarters on average four (4) days per work week during normal business hours.

• JD required.
• Bachelor’s Degree in a related field helpful.
• Minimum of 7-10 years of insurance industry experience in the life and health insurance areas with a strong regulatory compliance background.
• Familiarity with operational, quality assurance, anti-fraud regulations required.
• Knowledge of reporting requirements for multi-employer, self-funded, Taft Hartley retirement and health funds preferred.
• Knowledge of state abandoned property and NYS HCRA requirements a plus.
• Regulatory operations experience is helpful.
• Enterprise risk management experience helpful.
• Must have excellent written and verbal communication/presentation skills.
• Demonstrated project management experience.
• Ability to interpret and explain complex legal/regulatory matters to all staff.
• Customer oriented attitude with the ability to interface with all staff levels.
• Ability to negotiate and influence internal and external parties.
• Function under tight deadlines and may be subject to extreme pressure and workloads.
• Remains current in profession and industry trends.

Salary: 140K-200K

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