Legal Counsel Sr

For roles that are 100% remote or hybrid, you must have access to a reliable high-speed internet connection to support daily job responsibilities. A minimum bandwidth of 50 Mbps download and 5 Mbps upload is required. Those fully remote associates residing in states where service is required by contract, law, or regulation will be allowed to submit for reimbursement.

Your career starts now. We’re looking for the next generation of health care leaders.

At AmeriHealth Caritas, we’re passionate about helping people get care, stay well and build healthy communities. As one of the nation's leaders in health care solutions, we offer our associates the opportunity to impact the lives of millions of people through our national footprint of products, services and award-winning programs. AmeriHealth Caritas is seeking talented, passionate individuals to join our team. Together we can build healthier communities. If you want to make a difference, we’d like to hear from you.

Headquartered in Newtown Square, AmeriHealth Caritas is a mission-driven organization with more than 30 years of experience. We deliver comprehensive, outcomes-driven care to those who need it most. We offer integrated managed care products, pharmaceutical benefit management and specialty pharmacy services, behavioral health services, and other administrative services.

Discover more about us at www.amerihealthcaritas.com.

Role Overview:

Standard Legal Counsel, Sr. Summary: Provides strategic legal counsel and recommendations on complex legal matters. Applies established legal standards to protect the organization’s interests and reputation and support compliance with applicable laws and regulations. Advises business and functional leaders to help ensure that activities, policies, business practices, and transactions align with legal and regulatory requirements. Counsels senior management on legal issues and proposed regulatory changes. Demonstrates advanced knowledge in specialized legal disciplines and a strong understanding of the business, healthcare industry, and strategic context.

Product Counsel Focus: This Senior Legal Counsel role provides strategic legal counsel and regulatory guidance for the Company’s Exchange Marketplace business. The position partners closely with business and functional leaders to interpret regulatory requirements, assess legal and operational risks, and develop practical, business-oriented solutions. The role requires the ability to translate complex legal and regulatory concepts into clear, actionable guidance for executives and operational stakeholders and to influence outcomes effectively in a highly matrixed environment.

Work Arrangement:

• Remote within the United States
   

Responsibilities:

Regulatory Counseling and Legal Advice

• Advise business leaders and cross-functional stakeholders on legal and regulatory requirements applicable to the Exchange Marketplace business and other impacted health insurance products.
• Interpret federal and state laws, regulations, and agency guidance and provide practical, business-focused legal advice.
• Analyze emerging legislative and regulatory developments and communicate resulting legal, operational, and business impacts.
• Develop clear recommendations that support informed business decisions while managing legal and regulatory risk.

Risk Assessment and Issue Management

• Identify, evaluate, and communicate legal, regulatory, operational, and reputational risks associated with proposed business activities and strategic initiatives.
•  Assess risks based on severity, likelihood, business impact, and risk tolerance, and recommend mitigation strategies.
• Exercise sound judgment in balancing legal requirements, operational realities, member experience, and business objectives.
• Support resolution of complex legal and regulatory issues through practical and risk-balanced recommendations.

Strategic Business Partnership

• Partner with operations, compliance, network, finance, actuarial, government affairs, risk adjustment, sourcing and other business functions to support strategic initiatives and ongoing operations.
• Provide timely, solution-oriented legal counsel in support of product implementation, operational changes, regulatory requirements, member initiatives, and business process improvements.
• Influence and collaborate with stakeholders across a matrixed organization without direct reporting authority.
• Translate complex legal issues into clear, concise guidance tailored to executive, operational, and technical audiences.

Regulatory Change Management & Implementation

• Support implementation of new laws, regulations, and regulatory guidance affecting the Exchange Marketplace line of business.
• Collaborate with business stakeholders to identify operational impacts and develop compliant implementation strategies.
• Assist in the development, review, and enhancement of policies, procedures, communications, and business practices to support regulatory compliance.

Additional Legal Support

• Support special projects, regulatory inquiries, audits, examinations, and other legal matters as assigned.
• Contribute to departmental initiatives designed to improve legal service delivery, operational efficiency, and business partnership.

Education/Experience:

• Juris Doctorate (JD) degree from an accredited law school.
• Active bar membership in good standing.
• Minimum of eight (8) years of legal experience supporting managed care organizations, including substantial experience advising Exchange Marketplace business operations required.

Other Skills:

• Exceptional ability to synthesize complex legal and regulatory requirements into concise recommendations that support executive decision-making.
• Demonstrates strong judgment, intellectual rigor, and the ability to independently manage complex matters in a fast-paced and evolving regulatory environment.
• Proven ability to identify, assess, and communicate legal, regulatory, operational, and reputational risks.
• Ability to work independently, manage competing priorities, and deliver practical, solution-oriented legal advice with limited oversight.

Our Comprehensive Benefits Package

Flexible work solutions including remote options, hybrid work schedules, Competitive pay, Paid time off including holidays and volunteer events, Health insurance coverage for you and your dependents on Day 1, 401(k) Tuition reimbursement and more.