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Vice President, Associate General Counsel

Role overview

Qualifications

  • Juris Doctor (JD) required
  • 7+ years of experience in health law required
  • 2+ years of experience handling risk adjustment matters preferred
  • Bar Admission and currently in good standing required

Responsibilities

  • Provide legal advice and strategic support to Centene’s Medicare Advantage, Part D, and Duals products
  • Advise business and compliance partners on healthcare laws and regulations impacting Medicare
  • Research, analyze, and interpret complex healthcare regulatory requirements
  • Manage provider disputes

Key facts

Other skills

  • Decision Making
  • Leadership
  • Collaboration
  • Problem Solving
  • Communication

About the company

Centene Corporation logo

Centene Corporation

Health Insurance (Payers)

Centene Corporation provides high-quality healthcare services to members in all 50 states. Since its founding in 1984, Centene has worked to transform the health of communities, one person at a time. Centene is the largest Medicaid managed care organization in the country and provides a portfolio of services to government sponsored healthcare programs. Centene believes that healthcare is best delivered locally. Our local health plans offer a range of health insurance solutions with a focus on providing accessible care to uninsured and under-insured individuals. Many receive benefits provided under Medicaid, including the State Children's Health Insurance Program (CHIP), as well as Aged, Blind or Disabled (ABD), Foster Care and Long Term Care (LTC), in addition to other state-sponsored/hybrid programs, and Medicare (Special Needs Plans). Centene also contracts with other healthcare and commercial organizations to provide specialty services including behavioral health management, care management software, dental benefits management, in-home health services, life and health management, managed vision, pharmacy benefits management, specialty pharmacy and telehealth services. Centene’s hiring practices reflect the composition of the members and communities we serve, allowing us to deliver quality, culturally sensitive healthcare to millions of members. Centene employees help change the world of healthcare and transform our communities. To learn more about career opportunities with Centene, visit: https://jobs.centene.com/

Company details

Company typeXLarge
IndustryHealth Insurance (Payers)
Company size10001

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Job description

Centene is transforming the health of our communities one person at a time.  As an Executive on our team, you could be the one who changes everything for our 28 million members.
 

Provide legal advice and strategic support to Centene’s Medicare Advantage, Part D, and Duals products.

  • Serves as lead legal counsel for Wellcare, Centene’s Medicare brand.
  • Advise business and compliance partners on healthcare laws, regulations, and guidance impacting Medicare.
  • Research, analyze, and interpret complex healthcare regulatory requirements, including but not limited to issues related to Medicare operations, risk adjustment, MLR, quality, stars, and agent / broker matters.
  • Takes on increasing responsibility for national-level and/or Company-wide legal matters.
  • Reviews, drafts, and negotiates contracts, policies and procedures, and related documents.
  • Provides practical legal guidance to support implementation of new laws, regulations, business initiatives, policies and procedures, and operational workflows.
  • Manages provider disputes.
  • Partners with product leaders, Compliance, Population Health, Network, Finance, and other business leaders to identify risks, develop practical solutions, and support timely decision making.
  • Manages outside counsel as necessary to ensure the delivery of efficient, high quality legal services.
  • Performs other duties as assigned.
  • Complies with all policies and standards.

  • Juris Doctor (JD) required.
  • 7+ years of experience in health law required.
  • 2+ years of experience handling risk adjustment matters, including audits and complex vendor relationships preferred.
  • 2+ years of experience in Medicare Stars preferred.
  • 2+ years of experience advising on Medicare bids and benefit structures preferred.
  • 2+ years of people leadership experience preferred.
  • Bar Admission and currently in good standing required.
  • Or equivalent experience acquired through accomplishments of applicable knowledge, duties, scope and skill reflective of the level of this position.

Pay Range: $171,900.00 - $326,900.00 per year

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, including full-time or part-time status.  Total compensation may also include additional forms of incentives. Benefits may be subject to program eligibility.

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

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Marcus Rivera

Chief Revenue Officer

m.rivera@company.com
linkedin.com/in/marcusrivera
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