Legal Counsel Sr
AmeriHealth Caritas · United States · 1 wk ago
RemoteRemoteLegalFull-time
Role Overview
This Senior Legal Counsel role provides strategic legal counsel and regulatory guidance for the Company’s Exchange Marketplace business.
Product Counsel Focus
The position partners closely with business and functional leaders to interpret regulatory requirements, assess legal and operational risks, and develop practical, business-oriented solutions.
Work Arrangement
Remote within the United States
Responsibilities
- Regulatory Counseling and Legal Advice
- Advise business leaders and cross-functional stakeholders on legal and regulatory requirements applicable to the Exchange Marketplace business and other impacted health insurance products.
- Interpret federal and state laws, regulations, and agency guidance and provide practical, business-focused legal advice.
- Analyze emerging legislative and regulatory developments and communicate resulting legal, operational, and business impacts.
- Develop clear recommendations that support informed business decisions while managing legal and regulatory risk.
- Risk Assessment and Issue Management
- Identify, evaluate, and communicate legal, regulatory, operational, and reputational risks associated with proposed business activities and strategic initiatives.
- Assess risks based on severity, likelihood, business impact, and risk tolerance, and recommend mitigation strategies.
- Exercise sound judgment in balancing legal requirements, operational realities, member experience, and business objectives.
- Support resolution of complex legal and regulatory issues through practical and risk-balanced recommendations.
- Strategic Business Partnership
- Partner with operations, compliance, network, finance, actuarial, government affairs, risk adjustment, sourcing and other business functions to support strategic initiatives and ongoing operations.
- Provide timely, solution-oriented legal counsel in support of product implementation, operational changes, regulatory requirements, member initiatives, and business process improvements.
- Influence and collaborate with stakeholders across a matrixed organization without direct reporting authority.
- Translate complex legal issues into clear, concise guidance tailored to executive, operational, and technical audiences.
- Regulatory Change Management & Implementation
- Support implementation of new laws, regulations, and regulatory guidance affecting the Exchange Marketplace line of business.
- Collaborate with business stakeholders to identify operational impacts and develop compliant implementation strategies.
- Aid in the development, review, and enhancement of policies, procedures, communications, and business practices to support regulatory compliance.
- Additional Legal Support
- Support special projects, regulatory inquiries, audits, examinations, and other legal matters as assigned.
- Contribute to departmental initiatives designed to improve legal service delivery, operational efficiency, and business partnership.
Education/Experience
- Juris Doctorate (JD) degree from an accredited law school.
- Active bar membership in good standing.
- Minimum of eight (8) years of legal experience supporting managed care organizations, including substantial experience advising Exchange Marketplace business operations required.
Other Skills
- Exceptional ability to synthesize complex legal and regulatory requirements into concise recommendations that support executive decision-making.
- Demonstrates strong judgment, intellectual rigor, and the ability to independently manage complex matters in a fast-paced and evolving regulatory environment.
- Proven ability to identify, assess, and communicate legal, regulatory, operational, and reputational risks.
- Ability to work independently, manage competing priorities, and deliver practical, solution-oriented legal advice with limited oversight.
Benefits
Flexible work solutions including remote options, hybrid work schedules, Competitive pay, Paid time off including holidays and volunteer events, Health insurance coverage for you and your dependents on Day 1, 401(k)