Sanford Health is one of the largest and fastest-growing not-for-profit health systems in the United States. We’re proud to offer many development and advancement opportunities to our nearly 50,000 members of the Sanford Family who are dedicated to the work of health and healing across our broad footprint.

Facility: GSS National Campus

Location: Sioux Falls, SD

Address: 4800 W 57th St, Sioux Falls, SD 57108, USA

Shift: Varies

Job Schedule: Full time

Weekly Hours: 40.00

Salary Range: $53.00 – $87.50

Job Summary

Responsible for evaluating regulatory, legal, and operational risks associated with new and existing products, sales strategies, and benefit structures. Serves as a key partner to Sales, Operations, Legal, and Public Policy, providing expert guidance on federal and state regulations – including ERISA, ACA, Medicare Advantage, Medicaid, and commercial plan requirements – and assessing the potential impact of regulatory changes on business strategy. Analyze and assess regulatory and legal requirements across government and commercial health plan products including ACA, Medicare Advantage, Medicaid, DSNP, and self-funded/ERISA plans. Develop regulatory risk matrices and decision frameworks to support leadership in evaluating strategic opportunities. Translate federal and state regulations into practical, operational guidance for sales, operations, and product teams. Represent the organization in external policy discussions, industry workgroups, and regulatory engagement efforts as needed.

Qualifications

Juris Doctor (JD) degree required (active bar licensure not required)

Minimum of 8+ years of experience in health policy, regulatory strategy, or legal/regulatory roles within a health plan, law firm, consulting firm, or regulatory agency.

Extensive experience with ACA, Medicare Advantage, Medicaid, DSNP, and commercial plan regulations, including self-funded/ERISA Frameworks.

Benefits

Sanford Health offers an attractive benefits package for qualifying full-time and part-time employees. Depending on eligibility, a variety of benefits include health insurance, dental insurance, vision insurance, life insurance, a 401(k) retirement plan, work/life balance benefits, and a generous time off package to maintain a healthy home-work balance. For more information about Total Rewards, visit https://sanfordcareers.com/benefits .

Sanford is an EEO/AA Employer M/F/Disability/Vet. If you are an individual with a disability and would like to request an accommodation for help with your online application, please call 1-877-673-0854 or send an email to [email protected] .

Sanford Health has a Drug Free Workplace Policy. An accepted offer will require a drug screen and pre-employment background screening as a condition of employment.

Req Number: R-0220556

Job Function: Health Plan

Featured: No