Closing Date: 17th May, 2024

Description:

Locations: Preferred office locations include St. Louis, MO, Mason, OH, Indianapolis, IN or Louisville, KY. Other Anthem office locations may be considered.

This position will take part in An Advancing Health Beyond Healthcare Company's hybrid workforce strategy which includes virtual work and 1-2 days in office per week.

The Associate General Counsel is responsible for providing legal advice and recommendations for initiatives and projects developed in response to clients overall objectives and needs. Focus of work is on large scale and/or high financial level projects with broad department and/or organizational impact and moderate level of risk. Works as a strategic partner and decision maker with more senior leaders, and manages work independently.

This position will support the provider solutions team in several states for insured business.

How you will make an impact:
Primary duties with expert skill level and tasks with the most advanced complexity and broad/enterprise scale may include, but are not limited to:

Routinely works on complex problems in which analysis of situations and/or facts require an in-depth evaluation of various factors; or large scale enterprise initiatives with broad organizational impact.
Provide legal guidance on a range of health law, regulatory, contractual and operational matters.
Work as a strategic partner with assigned clients and provide legal advice and guidance on business strategies or various corporate initiatives; and assist with evaluating legal risks; propose alternatives to minimize risk where applicable.
Proactively assist provider contracting staff with legal issues that arise during contract negotiations.
Review proposed contract language changes; draft alternative language to protect the company's interests when needed.
Support development and roll-out of new provider contract templates.
Support provider disputes prior to litigation.
Assist in early resolution of provider disputes to avoid litigation; interface with opposing counsel as needed.
Support value-based contracting and negotiation of shared savings or risk arrangements.
Utilize contract management software to facilitate tracking of custom provisions and documentation of required approvals.
Review provider communications, including manuals, newsletters, and material change notices, to ensure compliance with legal and contractual requirements.
Assist with provider network filings; draft responses to comment letters; interact with regulators as needed.
Prepare settlement agreements, letters of intent, confidentiality agreements and other documents as needed.
May support the development paralegals on the legal team.
Reports to management any identified business exposure and associated risks as well as mitigation techniques being utilized.
Works autonomously and manages work independently; Determines methods and procedures on new assignments and may coordinate legal projects with other legal colleagues or subject matter experts.
Provide statutory/regulatory interpretation; review proposed legislation affecting the company's interactions with providers to identify implementation challenges and assist implementation team with interpretation of final bill language.

Minimum Requirements:
Requires a JD; current license to practice law; 9 years of specific industry and/or technical legal experience post licensure; or any combination of education and experience, which would provide an equivalent background.

Preferred Skills, Capabilities, and Experiences:

Health Insurance Law: An understanding of the principles, definitions, and nuances within health insurance law.
Federal Regulations: Knowledge of federal laws that regulate health insurance companies, including the ACA, ERISA, the No Surprises Act, and other federal statutes impacting health insurance.
Compliance: Understanding of regulatory compliance, how to ensure adherence to laws, regulations, guidelines, and specifications relevant to the health insurance business.
Contract Law: Experience interpreting, drafting and reviewing employer and member contracts and related materials.
Experience with provider agreements.
Working knowledge of state laws and regulations that apply to health plan operations.
Excellent communication skills and problem-solving competencies.
Commercial experience preferred. Experience working with providers is preferred.