Associate General Counsel (Medicare) at Centene

You could be the one who changes everything for our 28 million members. Centene is transforming the health of our communities, one person at a time. As a diversified, national organization, you’ll have access to competitive benefits including a fresh perspective on workplace flexibility.

Position Purpose:

• Provide legal advice and services including advising management concerning state and federal legislation with a focus on Medicare Advantage and Prescription Drug plans, regulations and other requirements applicable to Centene business activities and initiatives
• Serves as a lead resource to Centene departments and entities for research and interpretation of specific healthcare policies and regulations with a focus on Medicare.
• Provides legal advice to Centene entities to define and develop solutions to regulatory requirements that impact Medicare, and identifying and appropriately responding to regulatory risks or opportunities.
• Supports Government Relations and Compliance departments by assessing and translating complex legislation, rules and regulations into understandable information and facilitating analysis of compliance and implementation implications.
• Reviews, drafts and negotiates contracts, policies and procedures and related documents.
• Manages outside counsel and directs, and monitors and develops legal strategies in connection with Medicare business leaders.
• Directs and conducts training and preventative law activities.
• Acts as a lead Corporate Counsel on projects and certain matters.

For Health Plan Operations and Medicare:

• Serves as legal advisor to the Company and the Medicare business for regulatory and business matters, develops legal strategies, provides interpretation of proposed and promulgated laws, provides counsel with regards to grievances, appeals and provider dispute resolution, risk adjustment, benefits, sales and broker matters, and provides internal fact development and investigations relating to elevated matters requiring legal counsel and works closely with other departments such as the special investigative unit and compliance.
• Performs other duties as assigned.
• Complies with all policies and standards.

Education/Experience:
Juris Doctor (JD) required, 5+ years of experience in the areas of corporate or health law required
1+ years of experience with government contract law, health law and managed care preferred
Knowledge of Medicare and/or Medicaid insurance, state insurance and HMO regulations preferred
Bar Admission and currently in good standing preferred

Preferred Criteria:

Inhouse experience with Medicare Advantage and Prescription Drug Plans and an understanding of risk adjustment, Stars, broker/sales, grievances and appeals, utilization management, dual eligible special needs plans, medical loss ratios, and other areas of Medicare a plus.

Centene offers a comprehensive benefits package including: competitive pay, health insurance, 401K and stock purchase plans, tuition reimbursement, paid time off plus holidays, and a flexible approach to work with remote, hybrid, field or office work schedules. Actual pay will be adjusted based on an individual's skills, experience, education, and other job-related factors permitted by law. Total compensation may also include additional forms of incentives.

Centene is an equal opportunity employer that is committed to diversity, and values the ways in which we are different. All qualified applicants will receive consideration for employment without regard to race, color, religion, sex, sexual orientation, gender identity, national origin, disability, veteran status, or other characteristic protected by applicable law.

Qualified applicants with arrest or conviction records will be considered in accordance with the LA County Ordinance and the California Fair Chance Act