Counsel-TPA Operations

Lodestar Claims & Risk Services•Whitpain Township, PA

About The Position

The Counsel - TPA Operations is a hands-on attorney responsible for recurring business-facing legal and regulatory work for the Lodestar TPA. The role performs substantive legal work, manages paralegal or contract-administration resources, and improves existing processes. Aligned within Claim Operations, the position supports the Lodestar TPA enterprise. Counsel enables business-led contracting through templates, approved language, guardrails, and exception criteria. Business leaders retain ownership of customer relationships, commercial negotiations, and operating commitments. Counsel coordinates with shared-service and specialty legal resources when needed. The position provides independent practical legal advice, supports contracting and business operations, manages legal processes and resources, owns TPA regulatory licensing, and coordinates routine commercial disputes and specialty legal support. Counsel determines applicable legal and regulatory requirements and recommends appropriate action, while business leaders retain decision authority for commercial and operating matters within delegated authority.

Requirements

Juris Doctor (J.D.) degree from an accredited law school.
Active bar membership in good standing in at least one U.S. jurisdiction and ability to obtain and maintain required in-house registration or limited licensure.
Minimum 5 years of relevant legal experience.
Substantial experience with commercial agreements, practical legal and regulatory advice, and independent legal analysis.
Experience managing or effectively using paralegal or contract-administration resources.

Nice To Haves

5–8 years of relevant legal experience is preferred.
Experience in TPA operations, insurance, claims administration, or another regulated environment, including licensing or regulatory examinations.
Experience developing contract templates, playbooks, approval guardrails, and exception-based legal review.
Strong commercial judgment, drafting and negotiation skills, and ability to translate risk into practical business advice.
Ability to operate independently, manage priorities, determine when legal involvement adds value, and work effectively across the business.

Responsibilities

Provide independent, practical legal advice and distinguish legal or regulatory requirements from commercial considerations.
Communicate material risk, options, and recommended action while preserving business ownership of commercial and operating decisions.
Create and maintain standard customer agreements, amendments, renewals, exhibits, clauses, and negotiation guidance.
Enable business leaders to negotiate routine terms within approved templates and guardrails; review, draft, and negotiate defined exceptions and material deviations.
Review vendor agreements, RFPs, proposals, and due-diligence responses for material legal or regulatory issues and identify matters requiring specialized review or escalation.
Advise on contract interpretation, obligations, remedies, and material commitments, and standardize responses to recurring legal questions.
Manage legal intake, review, approval, execution, recordkeeping, and matter tracking while maintaining business continuity.
Improve processes using standards, exception criteria, templates, playbooks, controls, and escalation protocols; report on workload, exceptions, significant risks, and service levels.
Manage and prioritize paralegal or contract-administration resources, delegating execution while retaining legal accountability and quality standards.
Own the TPA regulatory licensing function, including renewals, registrations, appointments, and related filings, with administrative support from the paralegal.
Interpret regulatory requirements, advise leadership on material developments, and lead or coordinate inquiries, examinations, and remediation.
Coordinate with Claim Operations on compliance, adjuster licensing, and related responsibilities to ensure clear accountability and escalation.
Own or coordinate routine commercial and contract disputes, interpretation issues, and early resolution efforts.
Engage shared-service or specialty legal resources for litigation, E&O, high-risk disputes, privacy and cybersecurity, employment, governance, novel matters, or matters outside delegated authority; serve as TPA coordinating attorney when appropriate.
Determine applicable legal and regulatory requirements, provide independent analysis, and recommend appropriate action.