Counsel

About the role

Become a part of our caring community The Counsel provides a full range of legal advice and services. The Counsel work assignments involve moderately complex to complex issues where the analysis of situations or data requires an in-depth evaluation of variable factors. The Counsel typically a Legal generalist or provides counsel in a combination of disciplines. Begins to influence department’s strategy. Makes decisions on moderately complex to complex issues regarding technical approach for project components, and work is performed without direction. Exercises considerable latitude in determining objectives and approaches to assignments. Work at Home Requirements: To ensure Home or Hybrid Home/Office employees’ ability to work effectively, the self-provided internet service of Home or Hybrid Home/Office employees must meet the following criteria: At minimum, a download speed of 25 Mbps and an upload speed of 10 Mbps is required; wireless, wired cable or DSL connection is suggested. In certain roles, the minimum recommended internet speed required by Humana may not be sufficient for business needs. Humana reserves the right to require associates to upgrade their internet service if necessary. Work from a dedicated space lacking ongoing interruptions to protect member PHI / HIPAA information. While this is a remote position, occasional travel to Humana's offices for training or meetings may be required.

Responsibilities

Use your skills to make an impact Be a Part Of The Legal Team -- Use Your Legal Expertise To Drive Healthcare Strategy.

• Provide legal advice and support for Humana’s Medicare Advantage lines of business
• Advise on Medicare Advantage rules and regulations and related health care fraud and abuse laws, including the Anti-kickback statute and False Claims Act
• Draft contract provisions to address regulatory concerns
• Collaborate and consult with leaders throughout the company to ensure full compliance with applicable laws and regulations, and protection against external risk

Required Qualifications

• Juris Doctorate, with licensing in at least one state
• At least 3 years of experience in health law at a law firm or in-house health care organization
• Experience in Medicare, Medicaid, or similar regulatory work
• Strong legal research, analytical, and writing/oral communication skills
• Experience negotiating contracts
• Ability to work both independently under general supervision and within a team
• Ability to work in complex organization with diverse clients at all levels of the company

Preferred Qualifications

• Demonstrated knowledge of Medicare Advantage program
• Demonstrated knowledge of risk adjustment and the Stars quality program