Counsel

Humana

2d•$138,900 - $191,000•Remote

About The Position

The Counsel provides a full range of legal advice and services on moderately complex to complex matters requiring in-depth evaluation of variable factors. The role is typically that of a legal generalist or counsel in a combination of disciplines and begins to influence department strategy. The Counsel makes decisions about technical approaches for project components, works without direction, and exercises considerable latitude in determining objectives and approaches. Humana is seeking legal counsel to support the company and its management on its Medicare Advantage lines of business. The role advises on Medicare Advantage rules and regulations and related healthcare fraud and abuse laws, drafts contract provisions to address regulatory concerns, and collaborates with company leaders to help ensure compliance with applicable laws and regulations and protect against external risk. This is a remote position. Occasional travel to Humana offices for training or meetings may be required. Employees working from home or a hybrid home/office must have internet service with at least 25 Mbps download and 10 Mbps upload speeds and work from a dedicated space that protects member PHI/HIPAA information.

Requirements

Juris Doctorate and licensing in at least one state.
At least 3 years of health law experience at a law firm or in-house healthcare organization.
Experience in Medicare, Medicaid, or similar regulatory work.
Strong legal research, analytical, writing, and oral communication skills.
Experience negotiating contracts.
Ability to work independently under general supervision and within a team.
Ability to work in a complex organization with diverse clients at all levels of the company.

Nice To Haves

Demonstrated knowledge of the Medicare Advantage program.
Demonstrated knowledge of risk adjustment and the Stars quality program.
Experience in managed care and value-based contracting.

Responsibilities

Provide legal advice and support for Humana’s Medicare Advantage lines of business.
Advise on Medicare Advantage rules and regulations and related healthcare fraud and abuse laws, including the Anti-kickback Statute and False Claims Act.
Draft contract provisions to address regulatory concerns.
Collaborate and consult with leaders throughout the company to ensure compliance with applicable laws and regulations and protection against external risk.