Vice President, Associate General Counsel

Overview

Provide legal advice and strategic support for Medicare Advantage, Part D, and Duals products. Serve as lead legal counsel for the organization’s Medicare brand and advise business and compliance partners on healthcare laws, regulations, and guidance affecting Medicare.

Responsibilities

• Research, analyze, and interpret complex healthcare regulatory requirements, including matters involving Medicare operations, risk adjustment, medical loss ratio (MLR), quality, Medicare Stars, and agent and broker matters.
• Take on increasing responsibility for national-level and organization-wide legal matters.
• Review, draft, and negotiate contracts, policies and procedures, and related documents.
• Provide practical legal guidance supporting the implementation of new laws, regulations, business initiatives, policies and procedures, and operational workflows.
• Manage provider disputes.
• Partner with product leaders, Compliance, Population Health, Network, Finance, and other business leaders to identify risks, develop practical solutions, and support timely decision-making.
• Manage outside counsel as necessary to ensure efficient, high-quality legal services.
• Perform other duties as assigned.
• Comply with all policies and standards.

Requirements

• Juris Doctor (JD) required.
• 7+ years of experience in health law required.
• Bar admission and current good standing required.
• Equivalent experience acquired through accomplishments of applicable knowledge, duties, scope, and skill reflective of the level of this position may be considered.

Preferred Qualifications

• 2+ years of experience handling risk adjustment matters, including audits and complex vendor relationships.
• 2+ years of experience in Medicare Stars.
• 2+ years of experience advising on Medicare bids and benefit structures.
• 2+ years of people leadership experience.

Compensation & Benefits

• Pay range: $171,900.00 - $326,900.00 per year.
• Comprehensive benefits package including competitive pay, health insurance, 401K and stock purchase plans, tuition reimbursement, paid time off plus holidays, and a flexible approach to work with remote, hybrid, field, or office work schedules.
• Actual pay will be adjusted based on an individual’s skills, experience, education, and other job-related factors permitted by law, including full-time or part-time status.
• Total compensation may also include additional forms of incentives.
• Benefits may be subject to program eligibility.

Equal Opportunity

The employer is an equal opportunity organization committed to diversity. All qualified applicants will receive consideration for employment without regard to race, color, religion, sex, sexual orientation, gender identity, national origin, disability, veteran status, or other characteristic protected by applicable law.

Qualified applicants with arrest or conviction records will be considered in accordance with the LA County Ordinance and the California Fair Chance Act.