Assistant General Counsel for Health Plan Operations

Responsibilities

• Support claims processes, advising on adjudication and regulatory requirements
• Provide legal guidance on provider contracting and network management
• Ensure compliance with state regulatory requirements and health care laws
• Advisory on third-party delegation arrangements and compliance oversight
• Collaborate with teams on delegated entity oversight and monitoring
• Translate regulatory guidance into actionable recommendations for teams
• Assist in regulatory exams and audits, ensuring preparedness and compliance

Qualifications

• Licensed to practice in at least one state with 8-10 years of experience, including 2-4 years in-house
• Prior in-house experience at a health plan is preferred
• Strong knowledge of health care regulatory requirements and applicable laws
• Demonstrated business acumen with an ability to analyze legal issues from a business perspective
• Ability to build collaborative relationships with regulators and internal teams
• Excellent interpersonal, organizational, and communication skills
• Proactive, solutions-oriented mindset with effective multitasking and urgency

Benefits

• Employer-sponsored health, dental, and vision plans with low or no premium
• Generous paid time off package
• $100 monthly stipend for mobile or internet expenses
• Employee stock options available to all staff
• Bonus eligibility for most roles; commission for sales positions
• Comprehensive parental leave program
• 401K program with employer contributions