Managing Counsel – Head of Legal & Compliance

📋 Description

• Acts as the highest-ranking legal and compliance authority for the Allegiance business, serving as a trusted advisor to executive leadership and a vital member of the executive team.

• Collaborates with Cigna legal counsel and enterprise leadership to proactively address legal, regulatory, contractual, and enterprise risk issues, facilitating strategic goals while safeguarding the organization's reputation and fiduciary responsibilities.

• Exhibits executive professionalism, sound judgment, and discretion in all interactions with employees, clients, regulators, vendors, and the public, serving as a prominent role model for the Company.

• Offers strategic and practical legal advice to senior leadership across various business lines, balancing risk with organizational priorities.

• Directs legal and regulatory support, including tracking developments and acting as a key liaison with regulators and external partners.

• Manages the engagement, performance, and expenses of outside counsel to ensure the delivery of effective and cost-efficient legal services.

• Provides legal and compliance advice across essential functions, including sales, client onboarding, RFPs, contracting, and operations.

• Reviews, drafts, and negotiates intricate agreements (e.g., vendor, provider, BAAs, licensing) and establishes contracting standards.

• Supports corporate governance and entity management activities, encompassing filings and documentation.

• Oversees regulatory inquiries, complaints, and data requests, ensuring precise and timely responses.

• Offers legal oversight for critical operational areas (e.g., appeals, subrogation, overpayments, Medicare secondary payer issues).

• Collaborates with business leaders to address escalated client concerns and ensure compliant, risk-oriented outcomes.

• Leads and enhances the compliance program, covering HIPAA Privacy and Security, training, monitoring, investigations, and incident response.

• Aids in accreditation and audit readiness initiatives (e.g., URAC) and policy governance.

• Guides and develops Legal and Compliance team members, including direct supervision of the Compliance Director.

⛳️ Requirements

• JD required.

• Over 10 years of progressive legal experience, with substantial experience in a TPA, health plan, or heavily regulated healthcare environment required.

• Direct TPA experience is strongly preferred, with a proven understanding of operations, regulatory requirements, and client-facing dynamics.

• Demonstrated experience in leading and developing teams, with the ability to coach, influence, and drive performance.

• Exhibits executive presence, capable of effectively engaging, influencing, and advising senior leadership and external stakeholders.

• Strong knowledge of relevant laws and regulations (e.g., ERISA, HIPAA, insurance/TPA operations, contracting, employment law).

• Experience in supporting or leading compliance programs, including policy development, training, monitoring, and investigations.

• Exceptional judgment and the ability to provide practical, risk-based legal guidance in a complex environment.

• Strong analytical, drafting, and negotiation capabilities.

• Ability to manage competing priorities and function effectively in a fast-paced, changing environment.

• High level of professionalism, discretion, and the capability to handle sensitive matters.

🏝️ Benefits

• Medical, vision, dental, and well-being and behavioral health programs.

• 401(k).

• Company-paid life insurance.

• Tuition reimbursement.

• A minimum of 18 days of paid time off per year.

• Paid holidays.