Description:
Description:Centene is transforming the health of our communities one person at a time. As an Executive on our team, you could be the one who changes everything for our 28 million members.
Position Purpose:
Provide legal advice and strategic support to Centene's Medicare Advantage, Part D, and Duals products.
- Serves as lead legal counsel for Wellcare, Centene's Medicare brand.
- Advise business and compliance partners on healthcare laws, regulations, and guidance impacting Medicare.
- Research, analyze, and interpret complex healthcare regulatory requirements, including but not limited to issues related to Medicare operations, risk adjustment, MLR, quality, stars, and agent / broker matters.
- Takes on increasing responsibility for national-level and/or Company-wide legal matters.
- Reviews, drafts, and negotiates contracts, policies and procedures, and related documents.
- Provides practical legal guidance to support implementation of new laws, regulations, business initiatives, policies and procedures, and operational workflows.
- Manages provider disputes.
- Partners with product leaders, Compliance, Population Health, Network, Finance, and other business leaders to identify risks, develop practical solutions, and support timely decision making.
- Manages outside counsel as necessary to ensure the delivery of efficient, high quality legal services.
- Performs other duties as assigned.
- Complies with all policies and standards.
Education/Experience:
- Juris Doctor (JD) required.
- 7+ years of experience in health law required.
- 2+ years of experience handling risk adjustment matters, including audits and complex vendor relationships preferred.
- 2+ years of experience in Medicare Stars preferred.
- 2+ years of experience advising on Medicare bids and benefit structures preferred.
- 2+ years of people leadership experience preferred.
- Bar Admission and currently in good standing required.
- Or equivalent experience acquired through accomplishments of applicable knowledge, duties, scope and skill reflective of the level of this position.