Counsel-Client Contracting (eviCore )

Cigna Healthcare•Houston, TX

1d•$132,700 - $221,100•Remote

About The Position

Counsel will be a key member of the eviCore healthcare’s client contracting team, serving as a legal advisor to a key subsidiary of Cigna’s Evernorth business. This role will focus on providing legal guidance and solutions for regulatory and contract challenges impacting eviCore healthcare, which provides utilization review, quality management, and related medical benefits management services. This role requires seasoned judgment, significant contracting experience, the ability to negotiate directly with external clients, the ability to work independently, comfort with working through ambiguity, strong attention to detail, and regulatory expertise. To be successful, this individual must gain an understanding of eviCore’s business and pricing models and develop the ability to draft language to support novel and complex contract arrangements. The successful candidate will operate as a thought partner and collaborate with business leadership and other internal professionals, including those in: Sales and Product; Compliance; Government Affairs; Enterprise Risk Management; and Services & Solutions. This position requires a customer-focused mind-set and a keen understanding of the perspectives of key internal and external stakeholders, including growth, business leaders, customers and clients, and regulators and enforcement agencies. The Counsel must gain an understanding of applicable state and federal laws and regulations, including: laws pertaining to utilization management, third party administrators, risk-bearing or capitated arrangements, and federal and state privacy laws and regulations (including the HIPAA Privacy Rule).

Requirements

Juris Doctor required.
3-5 years of commercial contracting experience in positions of increasing responsibility, with at least a portion of practice focused on the negotiating and drafting of healthcare transactions.
Strong, independent decision-making ability and problem solving skills.
Ability to understand complex operations, technological, and financial issues related to eviCore's products.
Understands the importance of supporting business leaders to enable sustainable growth.
Able to render actionable legal advice within a matrixed business setting, balancing the need to avoid unnecessary or inappropriate risk with the need to achieve business goals.
Identifies and researches legal issues pertinent to Evernorth/eviCore and its interests, and assists in the development of clear recommendations regarding eviCore’s legal obligations and options.
Personable, highly collaborative individual with the ability to influence others and build strong professional relationships.
Consistent sound judgment and incisive, three-dimensional analytical abilities.
Outstanding verbal and written communications skills.
Highly organized with a strong attention to detail.
Intellectual flexibility; adept at reassessing priorities to ensure that internal and external expectations are fulfilled.
Strong ability to navigate through barriers to drive successful initiatives throughout the business.
Ability to multi-task and appropriately prioritize and manage multiple projects under tight deadlines.
Ability to work more than 40 hours per week.
If you will be working at home occasionally or permanently, the internet connection must be obtained through a cable broadband or fiber optic internet service provider with speeds of at least 10Mbps download/5Mbps upload.

Nice To Haves

Familiarity with concepts, practices, and procedures related to the managed care industry is preferred.

Responsibilities

Through the provision of innovative and risk based legal advice, support the product and business teams by ensuring compliant administration and contracting of the eviCore product suite.
Responsible for negotiating and drafting the legal and business terms of eviCore’s client contracts for all solutions and compensation models. This includes arrangements for the provision of eviCore solutions to Commercial, Medicare Advantage, and Medicaid (fee-for-service and managed Medicaid) populations enrolled in plans throughout the United States, with related legal and regulatory considerations.
Coordinate with fellow Legal and Enterprise Compliance partners to ensure the business partners are receiving consistent legal and regulatory support and are apprised of key risks and issues in a timely manner.
Identify key trends or gaps arising out of processes occurring in Evernorth's medical management and Service Operations areas.
Promote a culture of compliance, accountability, transparency and ethical decision-making.