Legal Counsel
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The role
Provide legal counsel for Medicare Advantage operations, advising business partners on regulatory, operational, and contractual matters under Medicare Part C, in-office three days per week.
Interpret and apply 42 C.F.R. Part 422, CMS guidance, and related health care laws to provider contracting, delegation oversight, member communications, and 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 protocols and exercise judgment within defined procedures to determine appropriate actions while contributing to risk identification and mitigation.
Requires JD, active license, and at least three years of healthcare or regulatory legal experience; Medicare Advantage or highly regulated industry experience preferred.
Interpret and apply 42 C.F.R. Part 422, CMS guidance, and related health care laws to provider contracting, delegation oversight, member communications, and 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 protocols and exercise judgment within defined procedures to determine appropriate actions while contributing to risk identification and mitigation.
Requires JD, active license, and at least three years of healthcare or regulatory legal experience; Medicare Advantage or highly regulated industry experience preferred.
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