Senior Counsel, Managed Care Operations

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

📋 Description

• Create, review, and negotiate a significant volume of agreements related to healthcare, which include:

• Agreements between plans and other payer contracts

• Participation contracts for providers and network agreements

• Arrangements based on value, shared savings, and risk-sharing

• Agreements concerning MSOs, IPAs, and delegated risk

• Vendor agreements and strategic partnerships

• Data sharing contracts and Business Associate Agreements (BAAs)

• Independently manage certain contract negotiations with limited supervision

• Deliver practical, business-focused legal advice that facilitates execution

• Collaborate closely with stakeholders from:

• Network Development

• Contracting

• Operations

• Finance

• Compliance; and

• Executive Leadership

• Assist in structuring complex agreements that balance growth, operational realities, and legal risks

• Recognize potential legal and regulatory concerns early and suggest actionable solutions

• Support informed and well-documented risk decisions that align with company priorities and regulatory compliance

• Provide counsel on California managed care and healthcare regulatory matters

• Aid in the development of innovative and evolving value-based care and risk-bearing models

• Assist in navigating delegated care and risk agreements

• Offer guidance on contract provisions that significantly affect operational execution

• Work closely with Compliance on regulatory interpretation and escalation processes

• Develop and enhance templates, playbooks, and negotiation strategies

• Optimize contracting workflows, ensuring consistency and reducing turnaround times

• Identify opportunities and methods to streamline legal processes

⛳️ Requirements

• Juris Doctor (JD) from a recognized law school

• Active California Bar license (mandatory)

• Over 6 years of experience in managed care and healthcare contracting within California

• Extensive experience in negotiating:

• Managed care and payer agreements

• Provider and network contracts

• Value-based or risk-based agreements

• MSO, IPA, and delegated risk structures

• Experience working in fast-paced, high-volume contracting settings

• Strong judgment, problem-solving, and critical thinking abilities

• Capacity to work independently with clear ownership and accountability

• In-house legal experience (Preferred)

• Background in supporting value-based care organizations or risk-bearing entities (Preferred)

• Experience in high-growth or evolving healthcare organizations (Preferred)

• Proficiency in scaling contracting processes, templates, and playbooks (Preferred)

🏝️ Benefits

• This role is eligible for remote work within the U.S.

• The national target salary for this position ranges from $290,000 to $325,000. Actual compensation will be based on geographic location (current or future), relevant experience, and other job-related factors.