Assistant General Counsel for Health Plan Operations
Job Description
A 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:
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Support the claims process, advising on claims adjudication, payment integrity, appeals, and related legal and regulatory requirements.
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Support the network development and management team and advise on provider contracting, provider relationships, credentialing, and related operational matters.
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Work with compliance to ensure adherence to state regulatory requirements, and advise on compliance with state and federal health care laws and regulations.
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Advise on delegation arrangements with third parties, including TPAs, PBMs, behavioral health vendors, and other delegated entities.
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Collaborate cross-functionally with internal teams to support delegated entity oversight programs, including compliance monitoring, remediation, and regulatory reporting obligations.
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Interpret new and evolving regulatory guidance and translate it into actionable recommendations for business and clinical teams.
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Support regulatory exams, audits, and inquiries from state departments of insurance and other regulatory agencies.
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Support the legally compliant implementation of clinical programs, quality initiatives, and utilization controls.
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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:
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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.
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Prior in-house experience at a health plan.
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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.
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Exercise strong business acumen and the ability to analyze legal issues from a business perspective.
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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.
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Outstanding interpersonal, organizational, and communication skills (effective speaking and written presentation), with the ability to work effectively across departmental lines.
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Proactive, solutions-oriented mindset, with the ability to navigate ambiguity and scale legal processes in a growing organization.
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Act with a high level of personal integrity, professionalism, intellectual curiosity, and willingness to grow.
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Ability to manage several varied tasks and assignments efficiently and effectively to meet deadlines with a high sense of urgency.
Desired skills and experience:
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Prior in-house experience for a Medicare Advantage plan will be considered an invaluable asset but is not required.
Salary range: $175,00 - $225,000 /year plus equity
The pay range listed for this posi