Legal Counsel Sr

Overview

This role involves providing strategic legal counsel and regulatory guidance for a health care organization's Exchange Marketplace business. The position requires partnering closely with business and functional leaders to interpret regulatory requirements, assess legal and operational risks, and develop practical, business-oriented solutions. The role demands translating complex legal and regulatory concepts into clear, actionable guidance for executives and operational stakeholders within a highly matrixed environment.

The position is fully 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 related health insurance products.
• Interpret federal and state laws, regulations, and agency guidance to 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.
• Assist 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.

Requirements

• 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.
• Exceptional ability to synthesize complex legal and regulatory requirements into concise recommendations that support executive decision-making.
• Strong judgment, intellectual rigor, and 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.

Additional Requirements

• For remote or hybrid roles, access to a reliable high-speed internet connection is required, with a minimum bandwidth of 50 Mbps download and 5 Mbps upload.
• Fully remote associates residing in states where service is required by contract, law, or regulation may be eligible to submit for reimbursement of internet costs.

Compensation & Benefits

• Flexible work solutions including remote options and hybrid work schedules.
• Competitive pay.
• Paid time off including holidays and volunteer events.
• Health insurance coverage for employees and dependents starting Day 1.
• 401(k) retirement plan.
• Tuition reimbursement and additional benefits.

Location

• Remote within the United States.