Legal Counsel
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Provides legal counsel to the Medicare Advantage line of business on regulatory, operational, and contractual matters under Medicare Part C.
Interprets and applies 42 CFR Part 422, CMS guidance, and applicable federal/state healthcare laws across provider contracting, delegation, member communications, grievances and appeals, and benefit administration.
Drafts and reviews provider and vendor agreements affecting MA operations; conducts legal research; supports audits and regulatory responses.
Collaborates with Compliance, Government Programs leadership, and operational teams to identify and mitigate legal and regulatory risk.
Follows department protocol and exercises judgment within defined procedures to determine appropriate actions.
Minimum requirements include a JD, active license, and at least 3 years of industry-specific legal experience; hybrid work arrangement with in-office presence required.
Interprets and applies 42 CFR Part 422, CMS guidance, and applicable federal/state healthcare laws across provider contracting, delegation, member communications, grievances and appeals, and benefit administration.
Drafts and reviews provider and vendor agreements affecting MA operations; conducts legal research; supports audits and regulatory responses.
Collaborates with Compliance, Government Programs leadership, and operational teams to identify and mitigate legal and regulatory risk.
Follows department protocol and exercises judgment within defined procedures to determine appropriate actions.
Minimum requirements include a JD, active license, and at least 3 years of industry-specific legal experience; hybrid work arrangement with in-office presence required.
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