Carelon Behavioral Health Legal Counsel Sr
Elevance Health, Atlanta, GA, United States
Location
This role requires associates to be in-office 3 days per week, fostering collaboration and connectivity, while providing flexibility to support productivity and work‑balance. This approach combines structured office engagement with the autonomy of virtual work, promoting a dynamic and adaptable workplace. Will consider candidates in additional locations other than those listed, with a preference for Eastern and Central time zones.
Please note that per our policy on hybrid/virtual work, candidates not within a reasonable commuting distance from the posting location(s) will not be considered for employment, unless accommodation is granted as required by law.
Primary Duties
Provide legal guidance on a range of health law, regulatory, contractual and operational matters.
Work as a strategic partner with assigned clients and provide legal advice and guidance on business strategies or various corporate initiatives; and assist with evaluating legal risks; propose alternatives to minimize risk where applicable.
Proactively assist provider contracting staff managing a behavioral health network with legal issues that arise during contract negotiations.
Review proposed contract language changes; draft alternative language to protect the company's interests when needed.
Support development and roll‑out of new provider contract templates.
Support provider disputes prior to litigation.
Assist in early resolution of provider disputes to avoid litigation; interface with opposing counsel as needed.
Assist with responding to regulatory inquiries or complaints.
Support value‑based contracting and negotiation of shared‑savings or risk arrangements.
Utilize contract management software to facilitate tracking of custom provisions and documentation of required approvals.
Review provider communications, including manuals, newsletters, and material change notices, to ensure compliance with legal and contractual requirements.
Prepare settlement agreements, letters of intent, confidentiality agreements and other documents as needed.
Report on identified business exposure and associated risks to management as well as mitigation techniques being utilized.
Works autonomously and manages work independently; determines methods and procedures on new assignments and may coordinate legal projects with other legal colleagues or subject matter experts.
Review provider communications, including manuals, newsletters, and material change notices, to ensure compliance with legal and contractual requirements.
Requirements
Requires a JD; current license to practice law; 6 years of specific industry and/or technical legal experience post‑licensure or any combination of education and experience, which would provide an equivalent background.
Ideal Candidate has
Health Insurance Law: An understanding of the principles, definitions, and nuances within health insurance law.
Knowledge of state laws impacting third‑party administrators.
Federal Regulations: Knowledge of federal laws that regulate health insurance companies, including MHPAEA, ERISA, ACA, and other federal statutes impacting health insurance.
Compliance: Understanding of regulatory compliance, how to ensure adherence to laws, regulations, guidelines, and specifications relevant to the health insurance business.
Contract Law: Experience interpreting, drafting and reviewing employer and member contracts and related materials.
Experience with provider agreements.
Working knowledge of state laws and regulations that apply to third‑party administrators or health plan operations.
Excellent communication skills and problem‑solving competencies.
Commercial and Government business—Medicare or Medicaid experience is preferred.
Experience working with providers is preferred.
For candidates working in person or virtually in the below locations, the salary range for this specific position is $160,336-$240,540.
Location(s):
Illinois, Minnesota
In addition to your salary, Elevance Health offers benefits such as a comprehensive benefits package, incentive and recognition programs, equity stock purchase, and 401k contribution (all benefits are subject to eligibility requirements). The salary offered for this specific position is based on a number of legitimate, non‑discriminatory factors set by the Company. The Company is fully committed to ensuring equal pay opportunities for equal work regardless of gender, race, or any other category protected by federal, state, and local pay equity laws.
The salary range is the range Elevance Health in good faith believes is the range of possible compensation for this role at the time of this posting. This range may be modified in the future and actual compensation may vary from posting based on geographic location, work experience, education, and/or skill level. Even within the range, the actual compensation will vary depending on the above factors as well as market/business considerations. No amount is wages or compensation until such amount is earned, vested, and determinable under the terms and conditions of the applicable policies and plans. The amount and availability of any bonus, commission, benefits, or any other form of compensation and benefits that are allocable to a particular employee remains in the Company’s sole discretion unless and until paid and may be modified at the Company’s sole discretion, consistent with the law.
We offer a range of market‑competitive total rewards that include merit increases, paid holidays, paid time off, and incentive bonus programs (unless covered by a collective bargaining agreement), medical, dental, vision, short and long term disability benefits, 401(k) + match, stock purchase plan, life insurance, wellness programs and financial education resources, to name a few.
Elevance Health is an Equal Employment Opportunity employer and all qualified applicants will receive consideration for employment without regard to age, citizenship status, color, creed, disability, ethnicity, genetic information, gender (including gender identity and gender expression), marital status, national origin, race, religion, sex, sexual orientation, veteran status or any other status or condition protected by applicable federal, state, or local laws. Applicants who require accommodation to participate in the job application process may contact elevancehealthjobssupport@elevancehealth.com for assistance.
Qualified applicants with arrest or conviction records will be considered for employment in accordance with all federal, state, and local laws, including, but not limited to, the Los Angeles County Fair Chance Ordinance and the California Fair Chance Act.
Prospective employees required to be screened under Florida law should review the education and awareness resources at HB531 | Florida Agency for Health Care Administration (https://info.flclearinghouse.com/).
#J-18808-Ljbffr
This role requires associates to be in-office 3 days per week, fostering collaboration and connectivity, while providing flexibility to support productivity and work‑balance. This approach combines structured office engagement with the autonomy of virtual work, promoting a dynamic and adaptable workplace. Will consider candidates in additional locations other than those listed, with a preference for Eastern and Central time zones.
Please note that per our policy on hybrid/virtual work, candidates not within a reasonable commuting distance from the posting location(s) will not be considered for employment, unless accommodation is granted as required by law.
Primary Duties
Provide legal guidance on a range of health law, regulatory, contractual and operational matters.
Work as a strategic partner with assigned clients and provide legal advice and guidance on business strategies or various corporate initiatives; and assist with evaluating legal risks; propose alternatives to minimize risk where applicable.
Proactively assist provider contracting staff managing a behavioral health network with legal issues that arise during contract negotiations.
Review proposed contract language changes; draft alternative language to protect the company's interests when needed.
Support development and roll‑out of new provider contract templates.
Support provider disputes prior to litigation.
Assist in early resolution of provider disputes to avoid litigation; interface with opposing counsel as needed.
Assist with responding to regulatory inquiries or complaints.
Support value‑based contracting and negotiation of shared‑savings or risk arrangements.
Utilize contract management software to facilitate tracking of custom provisions and documentation of required approvals.
Review provider communications, including manuals, newsletters, and material change notices, to ensure compliance with legal and contractual requirements.
Prepare settlement agreements, letters of intent, confidentiality agreements and other documents as needed.
Report on identified business exposure and associated risks to management as well as mitigation techniques being utilized.
Works autonomously and manages work independently; determines methods and procedures on new assignments and may coordinate legal projects with other legal colleagues or subject matter experts.
Review provider communications, including manuals, newsletters, and material change notices, to ensure compliance with legal and contractual requirements.
Requirements
Requires a JD; current license to practice law; 6 years of specific industry and/or technical legal experience post‑licensure or any combination of education and experience, which would provide an equivalent background.
Ideal Candidate has
Health Insurance Law: An understanding of the principles, definitions, and nuances within health insurance law.
Knowledge of state laws impacting third‑party administrators.
Federal Regulations: Knowledge of federal laws that regulate health insurance companies, including MHPAEA, ERISA, ACA, and other federal statutes impacting health insurance.
Compliance: Understanding of regulatory compliance, how to ensure adherence to laws, regulations, guidelines, and specifications relevant to the health insurance business.
Contract Law: Experience interpreting, drafting and reviewing employer and member contracts and related materials.
Experience with provider agreements.
Working knowledge of state laws and regulations that apply to third‑party administrators or health plan operations.
Excellent communication skills and problem‑solving competencies.
Commercial and Government business—Medicare or Medicaid experience is preferred.
Experience working with providers is preferred.
For candidates working in person or virtually in the below locations, the salary range for this specific position is $160,336-$240,540.
Location(s):
Illinois, Minnesota
In addition to your salary, Elevance Health offers benefits such as a comprehensive benefits package, incentive and recognition programs, equity stock purchase, and 401k contribution (all benefits are subject to eligibility requirements). The salary offered for this specific position is based on a number of legitimate, non‑discriminatory factors set by the Company. The Company is fully committed to ensuring equal pay opportunities for equal work regardless of gender, race, or any other category protected by federal, state, and local pay equity laws.
The salary range is the range Elevance Health in good faith believes is the range of possible compensation for this role at the time of this posting. This range may be modified in the future and actual compensation may vary from posting based on geographic location, work experience, education, and/or skill level. Even within the range, the actual compensation will vary depending on the above factors as well as market/business considerations. No amount is wages or compensation until such amount is earned, vested, and determinable under the terms and conditions of the applicable policies and plans. The amount and availability of any bonus, commission, benefits, or any other form of compensation and benefits that are allocable to a particular employee remains in the Company’s sole discretion unless and until paid and may be modified at the Company’s sole discretion, consistent with the law.
We offer a range of market‑competitive total rewards that include merit increases, paid holidays, paid time off, and incentive bonus programs (unless covered by a collective bargaining agreement), medical, dental, vision, short and long term disability benefits, 401(k) + match, stock purchase plan, life insurance, wellness programs and financial education resources, to name a few.
Elevance Health is an Equal Employment Opportunity employer and all qualified applicants will receive consideration for employment without regard to age, citizenship status, color, creed, disability, ethnicity, genetic information, gender (including gender identity and gender expression), marital status, national origin, race, religion, sex, sexual orientation, veteran status or any other status or condition protected by applicable federal, state, or local laws. Applicants who require accommodation to participate in the job application process may contact elevancehealthjobssupport@elevancehealth.com for assistance.
Qualified applicants with arrest or conviction records will be considered for employment in accordance with all federal, state, and local laws, including, but not limited to, the Los Angeles County Fair Chance Ordinance and the California Fair Chance Act.
Prospective employees required to be screened under Florida law should review the education and awareness resources at HB531 | Florida Agency for Health Care Administration (https://info.flclearinghouse.com/).
#J-18808-Ljbffr