Position Summary
The Senior Paralegal – Compliance (PSM) is a specialized compliance and legal support role dedicated exclusively to PSM and its self-funded, ERISA-governed group health plan. The role provides practical, audit-ready legal and regulatory support with a primary focus on corporate governance, ERISA-governed plans, plan documentation integrity, regulatory disclosures, plan design and benefit-program compliance, and operational risk controls.
This position serves as a direct resource to PSM’s Managers and functions as the primary internal compliance documentation and regulatory support resource for PSM’s compliance and regulatory function. The role requires strong corporate governance knowledge, ERISA technical knowledge, advanced paralegal judgment, excellent documentation discipline, and the ability to translate complex legal and regulatory requirements into usable operating standards for PSM. The Senior Paralegal provides legal and compliance support under the direction of PSM’s Managers and designated legal counsel. The position does not independently provide legal advice, amend the Plan, interpret Plan terms with binding effect, exercise discretionary authority over Plan administration or assets, or make final eligibility, benefit, claim, appeal, fiduciary, or regulatory determinations unless such authority is separately and expressly delegated in writing.
Key Responsibilities
ERISA Compliance & Plan Governance
· Maintain and organize corporate records, including operating agreements, joinders, equity/ownership records.
· Serve as a primary paralegal and compliance documentation resource for ERISA-governed health plan matters related to PSM.
· Maintain and organize plan documents, Summary Plan Descriptions, amendments, notices, disclosures, adoption materials, and related compliance documents.
· Work with outside and inside counsel to draft, review, and update plan documents, Summary Plan Descriptions, amendments, notices, disclosures, adoption materials, and related compliance documents.
· Support alignment with ERISA, DOL, IRS, ACA, HIPAA, COBRA, and other applicable regulatory requirements.
· Maintain Plan-level HIPAA privacy, security, breach-response, records-access, complaint, workforce-training, and sanctions documentation in coordination with PSM’s designated Privacy and Security Officials.
· Maintain a regulatory calendar for required filings, notices, disclosures, plan updates, and recurring compliance activities. Coordinate, track, and maintain supporting records for applicable Form 5500 filings, Summary Annual Reports, Summary Plan Descriptions, Summaries of Material Modifications, Summaries of Benefits and Coverage, Form 1094/1095 reporting, PCORI fee filings, RxDC submissions, gag-clause compliance attestations, Medicare Part D creditable-coverage notices, COBRA notices, HIPAA notices, and applicable state reporting.
· Monitor regulatory developments and summarize potential implications for PSM leadership and operational stakeholders. Support documentation of fiduciary governance processes, including meeting materials, written resolutions, delegations of authority, committee charters, conflicts disclosures, vendor-selection and monitoring records, fee and compensation reviews, prohibited-transaction analyses, and decision memoranda.
· Maintain an authority matrix distinguishing responsibilities of PSM, the Plan Administrator, named fiduciaries, committees, the TPA, and other delegated service providers.
Working Owner Structure & Plan Eligibility Substance
· Support documentation integrity for the Working Owner arrangement that underlies Plan eligibility, including operating agreements, joinders, equity/ownership records, Working Owner activity, and related governing instruments across PSM and its subsidiaries.
· Maintain documentation regarding Consumer Data Respondent (CDR) participation and survey/data-contribution activity. Maintain auditable records supporting each participating working owner’s ownership interest, bona fide service relationship, CDR obligations, completed services, guaranteed payments or other compensation, eligibility dates, contribution history, notices, and termination or reinstatement history.
· Coordinate with tax/finance/legal personnel on Schedule K-1 disclosures, partner-compensation matters, Form 1095-B filings and related state filings.
Document Control, Regulatory Records & Audit Readiness
· Own document version control, approvals, repository structure, and audit-ready record retention for PSM compliance materials.
· Maintain organized compliance files for plan documents, amendments, policies, regulatory guidance, correspondence, issue logs, and decision records.
· Support internal audits; external audits; regulatory reviews; transaction, vendor, banking, stop-loss, auditor, regulator, or other authorized due diligence requests; and, information requests.
· Ensure documentation reflects current practice, authorized approvals, and clear accountability for ownership and maintenance.
· Develop templates and checklists to improve consistency, speed, and defensibility of recurring compliance deliverables.
Legal Research, Interpretation & Executive Support
· Conduct legal and regulatory research under attorney or executive direction and translate findings into operationally useful summaries.
· Prepare issue matrices, compliance memoranda, summaries of regulatory requirements, and recommended action steps.
· Escalate material risks, unresolved legal questions, or ambiguity requiring outside counsel or executive review.
· Coordinate with outside counsel, networks, PBMs, benefit vendors, , TPAs, stop-loss partners, and internal functional leaders as needed.
· Provide direct support to senior leadership on special projects, regulatory requests, and PSM governance priorities.
Policy, SOP & Controls System Development
· Draft and maintain PSM compliance policies, SOPs, process maps, control checklists, and operating guidance.
· Translate regulatory requirements into practical workflows for claims, eligibility, client implementation, documentation, disclosures, and issue escalation. The role will not independently adjudicate claims or direct the TPA’s claim determinations.
· Support the design and maintenance of PSM controls related to document approvals, regulatory review, client communications, exceptions, and evidence retention.
· Partner with operations and compliance leaders to close control gaps and strengthen risk mitigation practices.
· Assist with training and reinforcement of compliance procedures for PSM-adjacent teams.
Risk Identification, Issue Management & Remediation
· Maintain a PSM compliance issue log, including ownership, severity, remediation steps, due dates, and closure evidence.
· Identify trends, recurring documentation gaps, process risks, or operational inconsistencies requiring leadership attention.
· Support corrective action plans and track remediation through closure.
· Ensure risk decisions, exceptions, and approvals are documented with sufficient rationale and supporting evidence.
· Prepare periodic risk summaries for PSM governance review.
Claims, Appeals & Participant Rights Oversight
· Monitor and document the performance of TPAs, COBRA administrators, pharmacy benefit managers, networks, stop-loss partners, brokers, and other Plan service providers against contractual responsibilities and applicable Plan requirements; maintain issue, escalation, and remediation records.
· Review templates and sample communications for consistency with Plan terms and applicable legal requirements, under attorney direction
· Track recurring claim and appeal issues, untimely determinations, overturned decisions, and corrective actions, without independently adjudicating individual claims or appeals.
Other Duties
· Perform other related duties as required to support PSM, compliance, legal, governance, and enterprise risk priorities.
Skills & Experience Required
· 7+ years of paralegal, legal operations, corporate, employee benefits, ERISA, healthcare, insurance, or regulatory compliance experience.
· Demonstrated working knowledge of ERISA-governed health plan requirements, plan documentation, reporting/disclosure obligations, and fiduciary governance concepts.
· Experience supporting complex health plan administration, self-funded plans, stop-loss arrangements, TPA operations, alternative risk structures, or specialized insurance products.
· Strong legal drafting, document review, research, version control, and audit-readiness skills.
· Ability to interpret complex regulatory requirements and convert them into practical SOPs, controls, checklists, and stakeholder guidance.
· Strong executive communication skills, including concise issue framing, risk escalation, and written recommendations.
· Exceptional attention to detail, judgment, confidentiality, and follow-through.
· Ability to operate with autonomy while maintaining appropriate escalation discipline.
· High proficiency with Microsoft Word, Excel, PowerPoint, Teams, and SharePoint or similar document repositories.
· Familiarity with partnership/LLC structures and governing documents (operating agreements, joinders, equity/ownership records), and comfort coordinating with tax/finance on partner compensation and Schedule K-1 reporting.
· Working understanding of controlled-group/single-employer plan analysis and the distinction between single-employer plans and multiple employer welfare arrangements (MEWAs).
Preferred Qualifications
· Paralegal certificate from an ABA-approved program or equivalent legal training.
· Bachelor’s degree or equivalent combination of education and relevant experience.
· Experience in corporate, healthcare, insurance, TPA, employee benefits, stop-loss, captive, or alternative risk environments.
· Familiarity with DOL audit processes, ERISA claims procedures, HIPAA privacy/security concepts, ACA requirements, COBRA, and plan disclosure obligations.
· Experience coordinating with outside counsel, carriers, vendors, TPAs, or regulatory agencies.
· Experience building compliance documentation systems, regulatory calendars, issue logs, and audit-ready control frameworks.
· Exposure to working-owner or owner-participant benefit structures, partnership taxation concepts (e.g., guaranteed payments), or other alternative plan-eligibility models.
· Experience reviewing administrative-services agreements, BAAs, PBM agreements, network agreements, stop-loss documentation, and other plan-vendor contracts.
· Familiarity with Form 5500, RxDC, gag-clause attestations, PCORI, SBCs, SMMs, COBRA, HIPAA, and federal claims-and-appeals requirements.
Tools and Systems (Experience Preferred)
· Microsoft Word, Excel, PowerPoint, Teams
· SharePoint or other document management systems
· Compliance tracking tools, issue logs, and audit repositories
· Plan documentation and contract management repositories
· Adobe Acrobat or similar PDF/document review tools
Pay: $100,000.00 - $120,000.00 per year
Benefits:
- 401(k) matching
- Dental insurance
- Employee assistance program
- Health insurance
- Life insurance
- Paid time off
- Vision insurance
Work Location: Hybrid remote in Omaha, NE 68164
