Health Plan Operations Counsel

Job Summary

Supporting health plan operations, the full-time Assistant General Counsel for Health Plan Operations will provide legal counsel on claims, network management, provider contracting, and regulatory compliance in a remote capacity.

Key responsibilities

• Advise on claims adjudication, payment integrity, and related legal requirements
• Support provider contracting and relationships, ensuring compliance with health care laws
• Collaborate with internal teams on delegated entity oversight and regulatory compliance

Required qualifications

• Licensed to practice in at least one state with 8-10 years of legal experience, including 2-4 years in-house
• Prior in-house experience at a health plan
• Strong knowledge of health care regulatory requirements relevant to health plan operations
• Proven ability to analyze legal issues from a business perspective and build collaborative relationships
• Proactive mindset with the ability to manage multiple tasks efficiently in a fast-paced environment