Health Benefit Plan Consulting Attorney

The Phia Group LLC is a thriving service oriented company headquartered in Canton Massachusetts As consultants we represent health plans nationwide providing our clients with innovative cost containment solutions through our unique service offerings As a result of our most valuable resource our talented and committed team we continue to enjoy high levels of growth Now we seek to add another Health Benefits Attorney to our team We are currently seeking a full time Healthcare Attorney with professional experience in the healthcare industry or in similar industries to solve complex issues presented by employers their health plans and those entities that service them The Health Benefits Attorney will play an instrumental role in supporting our consulting services and the continued growth and expansion of our business This individual will work closely with other attorneys and consultants on our legal team providing support on consulting transactional regulatory and compliance matters At The Phia Group whose mission is to provide high quality yet affordable healthcare to American employees and their families you can look forward to not only exceptional benefits for yourself but also being immersed in a company that was named one of USA Todays Top Workplaces for 2026 Meanwhile from a regional perspective The Boston Globe Courier Journal and Louisville Business First annually recognize our unwavering commitment to upholding an internal culture of inclusivity enjoyment and empathy for our valued employees by listing The Phia Group in their respective lists for the Top Places to Work Note This is a hybrid schedule and can provide a flexible teleworking schedule if appropriate Essential Duties Manage and support reviews of member and provider appeals grievances and complex claims issues particularly in self funded and ERISA regulated plansEvaluate benefit exclusions plan document terms and medical necessity disputes to determine appropriate claim outcomesCoordinate with applicable vendors to ensure timely and accurate facilitation of independent clinical reviewsReview determination letters appeal responses and other memberprovider facing communications to ensure legal sufficiency and regulatory complianceSupport internal audits agency audits corrective action plans and external regulator or client requests ensuring regulatory complianceConduct legal research on applicable law and regulations; draft consulting memoranda; provide consultative advice including analyses to our legal team for internal useReview healthcare industry contractsRespond to client inquiries regarding agency rules statutory requirements and legal complianceCommunicate with health plan administrators and other healthcare industry entities including by phone video conference or in person; answer questions regarding the administration of compliant health plans; explain applicable law or health plan terms clearly and conciselyDraft ERISA and ACA compliant health plan documents including MHPAEA required reportsAssist in resolving disputes between various players in the healthcare industryProvide a thorough analysis of health plans and other related documents; provide a summary of findings to our legal teamOther duties as assignedMinimum Qualifications Juris doctor from an accredited law school and admittance to a state bar active1 year of experience in the healthcare industry or in similar industries preferred ie employment law insurance law disability law workers compensation lawKnowledge of the latest developments in health law including a working understanding of the ACA ERISA MHPAEA and HIPAASuperior legal writing analytical and proofreading skills as well as strong attention to detailOutstanding organizational interpersonal and negotiation skillsAbility to work collaboratively or independently as needed and to work sensitively with confidential mattersAbility to effectively communicate and interact with various positions throughout our organization as well as with clientsAbility to successfully manage multiple projects whether large or small complex or simple simultaneouslyAbility to participate effectively and confidently in client phone calls including in occasional video conference callsAbility to anticipate issues and create and implement methods for optimizing results and minimizing risksAbility to develop a deep understanding of the business and our operational goalsComfortable working in a fast paced environmentHigh level of proficiency using Microsoft Word Excel and OutlookMust be self motivated and able to meet deadlines under pressurePreferred Qualifications Excellent academic credentialsStrong preference for experience working with health plans third party administrators andor health insurance carriersFamiliarity with administrative rules published by relevant federal agencies including HHS the DOL and the IRSKnowledge of CMS billing and payment rules and processes or medical coding generallyConfidence in public speakingWillingness to travelThe Phia Groups Commitment to Diversity The Phia Group is committed to creating a diverse environment and we are proud to be an equal opportunity employer All qualified applicants will receive consideration for employment without regard to race color religion gender gender identity or expression sexual orientation national origin genetics disability age or veteran status The Phia Group is also committed to compliance with all fair employment practices regarding citizenship and immigration status Working ConditionsPhysical Demands This position requires sitting at a workstation for prolong periods of time with reasonable breaks as needed and extensive computer work The workstation may be exposed to overhead fluorescent lighting and air conditioning This is a fast paced work environment in which you will be operating office equipment including personal computers copiers and fax machines External and internal applicants as well as position incumbents who become disabled as defined under the Americans with Disabilities Act ADA must be able to perform the essential job functions as listed herein either unaided or with the assistance of a reasonable accommodation to be determined by management on a case by case basis This job description is not intended to be and should not be construed as an all inclusive list of all of the job duties skills or working conditions associated with the position While it is intended to accurately reflect the positions associated activities and requirements the company reserves the right to modify add or remove duties and assign other duties as necessary Base Salary 90000 110000