Assistant General Counsel for Health Plan Operations

📋 Description

• Provide legal counsel on health plan ops: claims, payments, appeals, and regulatory needs.
• Advise on provider contracting, network development, credentialing, and ops.
• Partner with compliance to meet healthcare laws and plan requirements.
• Guide delegated arrangements with TPAs, PBMs, behavioral health providers.
• Support delegated entity oversight: compliance monitoring, remediation, reporting.
• Advise on regulatory examinations, audits, inquiries; translate regs into actions.

🎯 Requirements

• Active license to practice law in at least one U.S. state.
• 8-10 years of legal experience, including 2-4 in-house.
• Prior health plan environment experience.
• Strong knowledge of healthcare regulatory requirements for health plan ops.
• Ability to analyze issues with a business lens; provide practical recommendations.
• Excellent communication, collaboration, and relationship-building; Medicare Advantage desirable.

🎁 Benefits

• Fully remote position across the United States.
• Salary: $175,000 - $225,000 plus equity.
• Employer-sponsored medical, dental, and vision plans.
• Stock options and bonus eligibility.
• Generous PTO and parental leave.
• 401(k) plan with $100 monthly stipend.