Note: The job is a remote job and is open to candidates in USA. AmeriHealth Caritas is a mission-driven organization with more than 30 years of experience delivering comprehensive healthcare solutions. They are seeking a Senior Legal Counsel for the Exchange Marketplace to provide strategic legal and regulatory guidance, manage complex legal risks, and ensure compliance within the organization.
Responsibilities
- Advise business leaders and cross-functional stakeholders on legal and regulatory requirements applicable to the Exchange Marketplace business and other impacted health insurance products
- Interpret federal and state laws, regulations, and agency guidance and 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
- 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
- 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
- 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
- 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
Skills
- 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 required
- Exceptional ability to synthesize complex legal and regulatory requirements into concise recommendations that support executive decision-making
- Demonstrates strong judgment, intellectual rigor, and the 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
Benefits
- Flexible work solutions including remote options
- Hybrid work schedules
- Competitive pay
- Paid time off including holidays and volunteer events
- Health insurance coverage for you and your dependents on Day 1
- 401(k)
- Tuition reimbursement
Company Overview