Director of Regulatory Compliance – Large Group Health Insurance

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Evry Health

WebsiteLinkedInAll Job Openings

51 - 200 employees

Founded 2017

🏥 Healthcare

💼 Consulting

🛡️ Insurance

Healthcare • Consulting • Insurance

Evry Health is a modern, mobile-first health insurance company that provides fully insured employer health plans and personalized care teams. Built for midsize and larger employers (primarily in Texas), Evry offers no-copay, no-deductible plans, 24/7 virtual care, integrated wellness programs, and individualized support from nurses, nutritionists, and doctors to simplify costs and improve employee health. The company emphasizes a human, member-focused approach and digital tools (iOS/Android app) to deliver care and benefits.

📋 Description

• Lead regulatory work for entry into new states, including certificates of authority, insurer licensing, foreign qualification, and producer/agency licensing • Research and map state-specific insurance requirements to inform expansion decisions • Build a repeatable new-state licensing and filing playbook • Own or partner with Actuarial on SERFF rate and form filings and respond to DOI objections • Track state filing deadlines, renewals, periodic reporting, and maintain the master compliance calendar • Serve as primary contact with the Texas Department of Insurance and applicable state DOIs, NAIC, and CMS • Manage regulatory examinations, market conduct exams, inquiries, and complaint escalations • Monitor legislative and regulatory developments and translate them into business impact assessments • Design and maintain compliance policies, procedures, internal controls, and monitoring/testing programs • Partner with Legal and HR on producer and agent appointments, licensing, and training • Support regulatory and compliance risk management, including ORSA-related processes, risk registers, and leadership or Board reporting • Prepare compliance updates and risk assessments for executive leadership and the Board • Maintain documentation and audit trails demonstrating compliance readiness • Advise Product and Actuarial teams on regulatory feasibility • Train Claims, Member Services, and Sales teams on applicable regulatory requirements • Act as an internal consultant to help non-compliance teams understand regulatory obligations

🎯 Requirements

• Bachelor's degree required • 8+ years of progressive experience in health insurance regulatory compliance, including direct experience at a fully insured commercial health carrier • Familiarity with health insurance regulatory reporting requirements including Mental Health Parity, Prompt Pay, Market Conduct, Gold Card, Balance Billing, and Network Adequacy • Hands-on experience with state DOI rate/form filings and SERFF • Experience supporting or leading multi-state licensing and market entry for an insurance carrier • Strong working knowledge of state insurance codes, NAIC model laws/regulations, and federal requirements applicable to fully insured group and individual health coverage, including ACA market reforms, HIPAA administrative simplification, COBRA, and ERISA as applicable • Experience managing or responding to regulatory examinations and market conduct exams • Excellent written and verbal communication skills, with ability to translate complex regulatory requirements into practical business guidance • Highly organized, self-directed, and comfortable with significant ownership in a lean, fast-moving organization • Excellent time management and organizational skills • Must live in the United States within the CST or EST time zones • Company business hours are weekdays 9-5 CST • Must have a dedicated work area separate from other living areas that provides information privacy • Ability to keep company sensitive documents secure • Must live in a location with existing high-speed internet service • Preferred, not required: experience expanding a Texas-domiciled or Texas-licensed carrier; Texas Department of Insurance familiarity; early-stage compliance function building; network adequacy and provider contracting compliance; professional certifications such as CHC, CPCU, HIA, or AHIP; fully insured group employer product experience; ERM and ORSA-related reporting

🏖️ Benefits

• Remote position; whole company works remotely • Dedicated work area allowance/requirement for information privacy • Existing high-speed internet connection/service • Company business hours are weekdays 9-5 CST