Assistant Counsel

Overview

This role involves serving as a hands-on, individual-contributor Assistant Counsel and key legal partner to health plan and clinical operations. Reporting to the Chief Legal Officer, the position supports high-volume drafting, review, and negotiation of commercial agreements across provider, payer, and vendor contracting, as well as delegated entity oversight and regulatory compliance.

Work is remote within the United States.

Responsibilities

Health Plan, Payer & Network Contracting

• Draft, review, and negotiate provider network agreements, including fee schedules, value-based/risk-sharing exhibits, credentialing terms, and amendment/termination provisions.
• Support payer contracting, including value-based, shared-savings, and full-risk payer arrangements (attribution, quality metrics, reconciliation).
• Support CMS program agreements (e.g., ACO LEAD, MSSP), including data-sharing and beneficiary alignment.
• Draft, review, and oversee delegated entity agreements (e.g., TPAs, PBMs, behavioral health and utilization management vendors), including ongoing oversight, compliance monitoring, remediation, and regulatory reporting.
• Support employer and Marketplace contracting, including employer group plan, ASA, broker, and stop-loss agreements; ACA Marketplace issuer contracting, QHP certification, and enrollment-platform agreements.
• Support claims and payment integrity contracting, including claims adjudication, coordination of benefits, appeals and grievances, and payment integrity vendor agreements.

Clinical Operations & Medical Group Contracting

• Draft, review, and negotiate physician and clinician agreements, including employment, professional services, and medical director agreements; restrictive covenant/compensation provisions (per Texas law); and locum tenens arrangements.
• Draft and negotiate specialty and facility affiliation agreements (e.g., cardiology, dermatology, rheumatology, endocrinology, behavioral health, infusion) and hospital/ancillary provider arrangements for referral, coverage, and co-management.
• Draft and negotiate clinic and site agreements, including lease, amendment, and build-out agreements for clinics, express care sites, labs, and mobile health units; plus laboratory, imaging, DME, staffing, and other clinical vendor agreements.
• Support technology and privacy contracting, including EHR, care-coordination, and analytics/SaaS agreements, and related BAAs and data-sharing agreements under HIPAA and Texas privacy law.

Regulatory Compliance & Government Affairs

• Advise and support Compliance to ensure adherence to applicable Texas and federal health care laws for insurers, medical groups, and delegated entities.
• Support TDI, CMS, and other regulatory exams, audits, inquiries, and complaint responses.
• Support legally compliant implementation of clinical programs, quality initiatives, and utilization management controls.
• Monitor and communicate TDI, CMS, and other rulemaking and legislative developments, translating complex regulatory language into actionable guidance and internal resources (e.g., newsletters, practice briefs).
• Conduct regulatory research to support policy development, with a focus on the Texas insurance market, TDI guidance, and NAIC model act adoption.

Cross-Functional Partnership

• Partner with business leaders across departments to assess legal implications of key decisions and integrate regulatory/contractual considerations into health plan and clinical operations.
• Support compliance program design and internal audits/reviews to identify risks and improvement opportunities.
• Oversee implementation of the contract lifecycle management (CLM) solution and ensure adherence to best practices.

Requirements

• J.D. from an accredited law school and an active license to practice law in Texas or another U.S. state (with willingness to obtain Texas licensure/registration promptly).
• 6–8 years of relevant legal experience, including 1–2 years in-house, with substantial hands-on transactional contract drafting/negotiation experience.
• Prior in-house or law firm experience representing a health plan, managed care organization, or health system, with exposure to both payer- and provider-side contracting.
• Demonstrated skill drafting and negotiating a high volume and variety of commercial agreements (provider, payer/risk, delegation, vendor/technology, real estate).
• Working knowledge of health care regulatory requirements for health plan and clinical operations, including claims administration, provider contracting, and delegated entity oversight.
• Strong business acumen, including the ability to manage a large, varied docket, meet regulatory/business deadlines, and build relationships with regulators, counterparties, and internal partners.
• Outstanding communication and interpersonal skills, including negotiation directly with external counterparties.
• Proactive, solutions-oriented mindset able to navigate ambiguity and help scale legal and contracting processes in a fast-growing organization.
• High level of personal integrity, professionalism, and intellectual curiosity; ability to manage multiple tasks efficiently with a strong sense of urgency.

Preferred Qualifications

• Experience negotiating technology, data-sharing, and SaaS agreements in a regulated health care environment, including BAAs and data use agreements.
• Experience with the ACA and Health Insurance Marketplace, including QHP certification and issuer agreements.
• Advanced knowledge of the ACA, ERISA, HIPAA, and the No Surprises Act/balance billing rules.
• Experience with CMS value-based care models (e.g., ACO LEAD) or other Medicare/Medicaid value-based/risk arrangements.
• Certification in Healthcare Compliance (CHC) or similar credential.
• Prior in-house experience at a health insurer, ACO, or integrated delivery system.
• Experience with M&A or integration of clinical practices/operations, including transition services agreements and post-closing matters.

Compensation & Benefits

• Competitive salary and benefits.
• Professional development and growth opportunities.

Location

• Remote position — United States.

Equal Employment Opportunity

The employer is an Equal Opportunity Employer and does not discriminate on the basis of race, color, religion, sex, sexual orientation, gender identity, national origin, age, disability, veteran status, or any other characteristic protected by law. Applications are encouraged from people of all backgrounds.