Legal Counsel
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The role
Provide legal counsel to the Medicare Advantage line of business, advising on regulatory, operational, and contractual matters under Medicare Part C.
Interpret and apply 42 CFR Part 422, CMS guidance, and related healthcare laws across provider contracting, delegation and oversight, member communications, grievances and appeals, benefit administration.
Draft and review provider and vendor agreements affecting MA operations, conduct legal research, and support audit and regulatory response activities.
Collaborate with Compliance, Government Programs leadership, and operational teams to identify and mitigate legal and regulatory risk.
Apply department protocol and exercise judgment within defined procedures to determine appropriate actions.
Develop risk identification and mitigation skills within the health insurance industry to support career growth.
Interpret and apply 42 CFR Part 422, CMS guidance, and related healthcare laws across provider contracting, delegation and oversight, member communications, grievances and appeals, benefit administration.
Draft and review provider and vendor agreements affecting MA operations, conduct legal research, and support audit and regulatory response activities.
Collaborate with Compliance, Government Programs leadership, and operational teams to identify and mitigate legal and regulatory risk.
Apply department protocol and exercise judgment within defined procedures to determine appropriate actions.
Develop risk identification and mitigation skills within the health insurance industry to support career growth.
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