Closing Date: 9th May, 2026

Description:

Location: This role requires associates to be in-office 3 days per week, fostering collaboration and connectivity, while providing flexibility to support productivity and work-life balance. This approach combines structured office engagement with the autonomy of virtual work, promoting a dynamic and adaptable workplace. Will consider candidates in additional locations other than those listed, with a preference for Eastern and Central time zones.

Please note that per our policy on hybrid/virtual work, candidates not within a reasonable commuting distance from the posting location(s) will not be considered for employment, unless accommodation is granted as required by law

A proud member of the Elevance Health family of companies, Carelon Behavioral Health uses our powerful combination of experience, expertise, dedication and compassion to see what's possible and what's better. Born out of one of the largest healthcare systems organization in the United States, our rich history gives us a unique and valuable perspective on how to solve the most pressing healthcare challenges.

The Carelon Behavioral Health Legal Counsel Sr will help support the provider solutions team for insured, self-funded, and government business.

Primary duties include but are not limited to:

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 managing a behavioral health network 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.
Assist with responding to regulatory inquiries or complaints.
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.
Prepare settlement agreements, letters of intent, confidentiality agreements and other documents as needed.
Reports on identified business exposure and associated risks to management 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.
Review provider communications, including manuals, newsletters, and material change notices, to ensure compliance with legal and contractual requirements.

Requirements:

Requires a JD; current license to practice law; 6 years of specific industry and/or technical legal experience post licensure; or any combination of education and experience, which would provide an equivalent background.

Ideal Candidate has:

Health Insurance Law: An understanding of the principles, definitions, and nuances within health insurance law.
Knowledge of state laws impacting third party administrators.
Federal Regulations: Knowledge of federal laws that regulate health insurance companies, including MHPAEA, ERISA, ACA, 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 third party administrators or health plan operations.
Excellent communication skills and problem-solving competencies.
Commercial and Government business-Medicare or Medicaid experience is preferred.
Experience working with providers is preferred.

For candidates working in person or virtually in the below locations, the salary* range for this specific position is $160,336-$240,540