Senior Counsel

This is a fully remote position, open to applicants in United States.

📋 Description

• Prepare, negotiate, and finalize TPA client agreements, which include administrative services agreements, renewals, amendments, fee schedules, performance guarantees, business associate agreements, and provisions for implementation, transition, and termination.

• Manage agreements related to wellbeing platforms and services, as well as strategic partnership and channel agreements.

• Negotiate contracts with vendors, networks, and partners encompassing provider networks, rental network access, pharmacy benefits, stop-loss arrangements, cost-containment strategies, claims editing, care navigation, and point-solution vendors.

• Provide guidance on ERISA and health plan compliance during contracting, including fiduciary responsibilities, plan administrator role allocation, plan documents and SPDs, claims and appeals procedures, COBRA, the No Surprises Act, and transparency mandates.

• Address contract interpretation inquiries, client and vendor escalations, and disputes for Sales, Account Management, Finance, Operations, and Procurement teams.

• Develop and maintain contract templates, negotiation playbooks, and fallback strategies.

• Evaluate risks and offer clear recommendations to business stakeholders and leadership.

• Counsel executives on deal structures, risk trade-offs, and commercial terms.

• Independently oversee a high-volume practice and transactions from initial intake to execution.

• Report directly to the SVP, Legal.

⛳️ Requirements

• Juris Doctor degree and active license in good standing in at least one U.S. state.

• Minimum of 5 years of legal practice experience.

• Strong preference for experience in the self-funded health plan sector, acquired at a TPA, health plan, national carrier, provider network, PBM, stop-loss carrier, or a law firm serving these clients.

• Proven experience advising senior leaders and executive team members.

• Solid understanding of ERISA and related health plan compliance, including HIPAA, COBRA, the ACA, and the No Surprises Act.

• Knowledge of TPA operations, including eligibility and enrollment, claims adjudication and payment, provider network access and repricing, stop-loss coordination, and plan sponsor funding arrangements.

• Familiarity with the roles of plan sponsors, plan administrators, and TPAs under ERISA, including distinctions for governmental and church plans.

• Expertise in contract drafting and negotiation across a wide range of agreement types.

• Financial acumen concerning fee structures, performance guarantees, and service-level commitments.

🏝️ Benefits

• Competitive base salary.

• Comprehensive medical and dental coverage through our own health solutions.

• Unlimited paid time off (PTO).

• Mental health support services.

• Retirement planning assistance.

• Financial protection options.

• Opportunities for professional development.

• Clear pathways for career advancement.

• Learning budgets for continuous education.

• Mission-driven workplace culture.

• Wellness programs for employee well-being.

• Additional employee perks.

• Full benefits package effective from day one.