Job DescriptionA bit about this role: The Assistant General Counsel for Health Plan Operations serves as a key legal partner to Devoted's health plan operations, providing practical, business-minded counsel across the full range of activities that keep our Medicare Advantage and related products running. This individual-contributor role reports to the Deputy General Counsel and supports claims, network development and management, provider contracting, delegated entity oversight, and regulatory compliance, translating a complex and evolving legal landscape into actionable guidance for business and clinical teams.
The successful candidate combines strong health care regulatory knowledge with sharp business acumen, thrives in a fast-moving environment, and builds trusted, collaborative relationships across the organization. This is a hands-on advisory role for an attorney who enjoys solving operational problems, moving with urgency, and having a direct impact on how care is delivered to our members.
Your Responsibilities and Impact will include: - Support the claims process, advising on claims adjudication, payment integrity, appeals, and related legal and regulatory requirements.
- Support the network development and management team and advise on provider contracting, provider relationships, credentialing, and related operational matters.
- Work with compliance to ensure adherence to state regulatory requirements, and advise on compliance with state and federal health care laws and regulations.
- Advise on delegation arrangements with third parties, including TPAs, PBMs, behavioral health vendors, and other delegated entities.
- Collaborate cross-functionally with internal teams to support delegated entity oversight programs, including compliance monitoring, remediation, and regulatory reporting obligations.
- Interpret new and evolving regulatory guidance and translate it into actionable recommendations for business and clinical teams.
- Support regulatory exams, audits, and inquiries from state departments of insurance and other regulatory agencies.
- Support the legally compliant implementation of clinical programs, quality initiatives, and utilization controls.
- Work closely with cross-functional team members and business leaders to review legal issues and the implications of potential business decisions and initiatives.
Required skills and experience: - Licensed to practice in at least one state, with eight to ten (8-10) years of experience, including a minimum of two to four (2-4) years of in-house experience.
- Prior in-house experience at a health plan.
- Knowledge of health care regulatory requirements applicable to health plan operations, including claims, provider contracting, delegation and delegated entity oversight, and state and federal health care laws and regulations.
- Exercise strong business acumen and the ability to analyze legal issues from a business perspective.
- Proven ability to follow through on complex issues, meet regulatory deadlines, proactively anticipate requirements, and build strong, collaborative relationships with regulators and internal business partners.
- Outstanding interpersonal, organizational, and communication skills (effective speaking and written presentation), with the ability to work effectively across departmental lines.
- Proactive, solutions-oriented mindset, with the ability to navigate ambiguity and scale legal processes in a growing organization.
- Act with a high level of personal integrity, professionalism, intellectual curiosity, and willingness to grow.
- Ability to manage several varied tasks and assignments efficiently and effectively to meet deadlines with a high sense of urgency.
Desired skills and experience: - Prior in-house experience for a Medicare Advantage plan will be considered an invaluable asset but is not required.
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Salary range: $175,00 - $225,000 /year plus equity
The pay range listed for this position is the range the organization reasonably and in good faith expects to pay for this position at the time of the posting. Once the interview process begins, your talent partner will provide additional information on the compensation for the role, along with additional information on our total rewards package. The actual base salary offered will depend on a variety of factors, including the qualifications of the individual applicant for the position, years of relevant experience, specific and unique skills, level of education attained, certifications or other professional licenses held, and the location in which the applicant lives and/or from which they will be performing the job.
Our Total Rewards package includes:
- Employer sponsored health, dental and vision plan with low or no premium
- Generous paid time off
- $100 monthly mobile or internet stipend
- Stock options for all employees
- Bonus eligibility for all roles excluding Director and above; Commission eligibility for Sales roles
- Parental leave program
- 401K program
- And more....
*Our total rewards package is for full time employees only. Intern and Contract positions are not eligible.
