Closing Date: 19th September, 2025

Description:

Hybrid 1: This role requires associates to be in-office 1 - 2 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. Alternate locations may be considered.

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

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 An Advancing Health Beyond Healthcare Company family of companies, Carelon Behavioral Health, formerly Beacon Health Options, offers superior clinical mental health and substance use disorder management, a comprehensive employee assistance program, work/life support, specialty programs for autism and depression, and insightful analytics to improve the delivery of care.

The Legal Counsel Is Responsible for Assisting More Experienced Attorneys in A Variety of Routine Legal Assignments and Projects and Providing Solutions to A Limited Range of Legal Problems of Moderate Scope and Impact.

How You Will Make an Impact:

Contributes to The Overall Results of The Team by Providing Solutions to A Limited Range of Legal Problems of Moderate Scope and Impact.
At This Level the Attorneys Focus Is More of A Tactical Nature.
Applies Department Protocol, Exercises Judgment Within Defined Procedures and Practices to Determine Appropriate Actions.
May Research Legal Principles and Precedents, Consult with Higher Level Attorneys, Draft and Execute Legal Documents, and Gather Relevant Case Related Information.
Learns About Risk Identification and Mitigation in The Context of The Health Insurance Industry or The Attorney's Technical Area of Expertise.
Reports to Department Management Any Identified Business Exposure and Associated Risks as Well as Mitigation Techniques Being Utilized.
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.
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.
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 and A Minimum of 3 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.
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 Is Preferred.
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.

Please Be Advised that An Advancing Health Beyond Healthcare Company only Accepts Resumes for Compensation from Agencies that Have a Signed Agreement with An Advancing Health Beyond Healthcare Company. Any Unsolicited Resumes, Including Those Submitted to Hiring Managers, Are Deemed to Be the Property of An Advancing Health Beyond Healthcare Company.