Senior Counsel - Employment, Litigation, and Investigations

Overview

This role provides strategic legal guidance for a multi-state healthcare organization. Responsibilities focus on healthcare regulatory compliance, complex contracting, fraud, waste and abuse (FWA) risk mitigation, and product counseling. The position partners with product, compliance, network, operations, clinical, and commercial teams to deliver practical, business-oriented legal advice related to contracting strategy, regulatory compliance, and product development.

Responsibilities

• Provide legal and regulatory guidance to ensure compliance with healthcare laws, privacy and security requirements, fraud and abuse regulations, and licensing/accreditation standards; advise stakeholders on associated risks and mitigation strategies.
• Monitor evolving healthcare legislation and regulatory changes; support compliance policies and training.
• Partner with product and operational teams to assess legal implications of care delivery models, value-based programs, and new healthcare service initiatives.
• Draft, review, and negotiate healthcare-related contracts, including vendor, provider, clinical services, administrative services, and technology agreements, while ensuring legal and regulatory compliance.
• Advise business leaders on structuring compliant healthcare partnerships, care coordination, and value-based care arrangements.
• Support RFPs, partnership proposals, and sales materials to ensure regulatory alignment and risk mitigation.
• Provide strategic guidance on privacy and data protection matters, including HIPAA, HITECH, and applicable state privacy laws.
• Partner with Compliance and Privacy teams to assess regulatory risk, support audits, and respond to government inquiries or investigations.
• Work cross-functionally with quality, network, compliance, finance, clinical, and commercial teams to ensure contractual and operational models are legally compliant and aligned with business objectives.
• Serve as a key legal advisor to commercial teams, including support for strategic partnerships, value-based arrangements, and vendor integration.

Requirements

• Juris Doctor (JD) degree from a nationally accredited law school.
• Active bar membership in good standing.
• 5+ years’ experience practicing law in an in-house or law firm environment.
• Deep understanding of healthcare fraud and abuse laws (AKS, Stark, CMP, etc.) and how they apply to clinical integration, downstream provider contracting, and risk-based models.
• Familiarity with behavioral health care systems, Medicare Advantage, and risk adjustment methodologies.
• Proven ability to translate complex legal requirements into practical, business-oriented solutions.
• Strong analytical, negotiation, and communication skills.
• Ability to align legal strategy with business goals and understand operational impact of legal decisions.
• Ability to pass background check upon hire and throughout employment to include:
  • criminal felony & misdemeanor search
  • SSN validation/trace search (LEIE)
  • education report (highest degree obtained)
  • civil upper and lower search
  • 7-year employment report
  • federal criminal search
  • statewide criminal search
  • widescreen plus national criminal search
  • health care sanctions-state med (SAM)
  • national sex offender registry
  • prohibited parties (OFAC) (terrorist watchlist)
  • 10-Panel Drug Screen

Preferred Qualifications

• Not specified.

Compensation & Benefits

• Annual compensation between $140,000 - $180,000, PLUS an annual performance-based, discretionary incentive.
• Compensation is dependent on non-discriminatory factors including but not limited to an applicant's skills, education/degrees, certifications, prior experience, market data, and other relevant factors.
• Comprehensive health benefit options: Medical, dental, and vision coverage
• 401(k) with competitive employer match
• Company-paid life and disability insurance
• Paid parental leave and wellbeing incentives
• Generous paid time off, including volunteer time
• Flexible spending accounts for healthcare and dependent care
• Professional development opportunities and tuition reimbursement
• Remote work flexibility (role-dependent)

Location

• Work is performed from home with company-provided equipment.

Working Conditions & Technical Requirements

• High-speed internet service (cable or fiber optic) with minimum download speed of 20 Mbps, upload speed of 5 Mbps, and maximum latency of 100 milliseconds (must be installed before starting) required.
• Frequent use of computer and phone systems.
• Must be able to remain in a stationary, sitting position, communicate and exchange information with others, inspect information, perform repetitive motions with arms and fingers, interpret data, problem solve, make decisions, organize and plan, and maintain a positive and professional attitude in all situations.
• A quiet workspace with minimal background noise for calls.
• For roles requiring travel: must be able to travel by air to various locations and stay overnight in hotels as needed for business purposes, including managing travel logistics, adapting to varying time zones and environments, and adapting to varying worksite conditions.

Application Notes

This position will accept and review new applications and resumes no less than 5 business days after the original posting date and may remain open an extended period of time with no set end date based on the level of interest.