Legal Counsel - Provider Network Services

Overview

This role supports Provider Network Services legal and business teams across a wide range of health care provider matters, including complex provider contract negotiations and related risk and dispute resolution. Support may also extend to Medical Management and Utilization Management areas.

The ideal candidate is located mid-Atlantic or Northeast, with hybrid/remote possibility.

Responsibilities

• Advise the business on regulatory exams, inquiries, and filings involving provider network matters.
• Advise, prioritize, and develop mitigation planning for legal risks related to provider network relationships.
• Provide provider contracting support, including complex health care system negotiations and risk-based arrangements.
• Work with the business and internal/external counsel to resolve provider disputes prior to arbitration/litigation.
• Collaborate with the business on development and review of sensitive internal and external communications to stakeholders (senior executives, regulators, lawmakers, advocates, members).
• Collaborate with Medicare and Medicaid counsel to conduct federal and state-specific legal research involving provider network services for government lines of business.
• Serve as a subject matter expert for assigned health care provider issue areas.
• Provide day-to-day risk management support for internal business clients responsible for provider networks in the assigned region.
• Identify and track policies and practices that can lead to issues, and develop solutions balancing legal considerations and business objectives.
• Build and maintain positive working relationships with clients.

Required Qualifications

• Actively practicing attorney with 5+ years demonstrated experience in a law firm and/or in-house setting, including experience with healthcare or other regulatory matters; experience drafting and negotiating complex contracts and/or interacting with government regulators or agencies with respect to healthcare matters.
• Admitted to practice law in at least one state and in good standing.
• 3+ years of experience with contracts and related issues.
• Ability to travel up to 5% (including by plane).
• Juris Doctor from an ABA-accredited institution.

Preferred Qualifications

• Experience with utilization management processes and regulations.
• Demonstrated business judgment and acumen.
• Superior oral and written communication skills.
• High level of interpersonal skills and ability to manage multiple responsibilities.

Compensation & Benefits

• Typical pay range: $144,200.00 - $288,400.00
• This range represents the base hourly rate or base annual full-time salary for all positions in the job grade.
• Actual base salary offer depends on factors including experience, education, geography, and other relevant factors.
• Eligibility for a bonus, commission, or short-term incentive program in addition to the base pay range.
• Includes an award target in the equity award program.

Benefits for this full-time position may include medical, dental, and vision coverage; paid time off; retirement savings options; wellness programs; and other resources, based on eligibility.

Additional details about available benefits are provided during the application process.

Location

Mid-Atlantic or Northeast (hybrid/remote possibility).

The anticipated application window for this opening will close on: 11/03/2026.

Qualified applicants with arrest or conviction records will be considered for employment in accordance with all federal, state and local laws.