Assistant General Counsel for Health Plan Operations

Devoted Health • Waltham, MA

11d • $175,000 - $225,000 • Remote

About The Position

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.

Requirements

• 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.
• Prior in-house experience at a health plan.
• 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.
• Exercise strong business acumen and the ability to analyze legal issues from a business perspective.
• 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.
• Outstanding interpersonal, organizational, and communication skills (effective speaking and written presentation), with the ability to work effectively across departmental lines.
• Proactive, solutions-oriented mindset, with the ability to navigate ambiguity and scale legal processes in a growing organization.
• Act with a high level of personal integrity, professionalism, intellectual curiosity, and willingness to grow.
• Ability to manage several varied tasks and assignments efficiently and effectively to meet deadlines with a high sense of urgency.

Nice To Haves

• Prior in-house experience for a Medicare Advantage plan will be considered an invaluable asset but is not required.

Responsibilities

• Support the claims process, advising on claims adjudication, payment integrity, appeals, and related legal and regulatory requirements.
• Support the network development and management team and advise on provider contracting, provider relationships, credentialing, and related operational matters.
• Work with compliance to ensure adherence to state regulatory requirements, and advise on compliance with state and federal health care laws and regulations.
• Advise on delegation arrangements with third parties, including TPAs, PBMs, behavioral health vendors, and other delegated entities.
• Collaborate cross-functionally with internal teams to support delegated entity oversight programs, including compliance monitoring, remediation, and regulatory reporting obligations.
• Interpret new and evolving regulatory guidance and translate it into actionable recommendations for business and clinical teams.
• Support regulatory exams, audits, and inquiries from state departments of insurance and other regulatory agencies.
• Support the legally compliant implementation of clinical programs, quality initiatives, and utilization controls.
• Work closely with cross-functional team members and business leaders to review legal issues and the implications of potential business decisions and initiatives.

Benefits

• Employer sponsored health, dental and vision plan with low or no premium
• Generous paid time off
• $100 monthly mobile or internet stipend
• Stock options for all employees
• Bonus eligibility for all roles excluding Director and above; Commission eligibility for Sales roles
• Parental leave program
• 401K program

What This Job Offers

• Job Type: Full-time
• Career Level: Senior
• Education Level: No Education Listed