Sr Legal Counsel
22 hours ago
Job Description
The Senior Counsel will support Aetna's managed-care operations in California and other states by providing legal guidance, interpretation, advice, and recommendations for action to senior business executives and other internal stakeholders regarding state insurance and managed-care laws and regulations (including the Knox-Keene Act) that impact Aetna's business activities and operations. In California, those operations include administration of various group commercial, individual/marketplace, Medicaid, and Medicare plans, including those offered through a joint venture with a regional provider system. The Senior Counsel will provide legal support for the existing operations and expansion opportunities of each of those plans, along with state subject-matter expertise and support in a challenging multi-regulator environment (given that the California DMHC, the California DHCS, the California Department of Insurance, and Covered California all oversee Aetna plans). The Senior Counsel will also manage one direct report: a regulatory-affairs professional who primarily supports California filings/issues.
This position may be located anywhere within California.
Responsibilities and Duties
The Senior Counsel will have the following responsibilities and duties for California and certain other states, in partnership with senior attorneys on the team:
- Provide legal, public-policy, and business counseling with respect to prospective, new, and existing business activities, including Aetna's group commercial, individual/marketplace, Medicaid, and Medicare businesses.
- Analyze applicable state insurance and/or managed-care laws, regulations, and sub-regulatory guidance and advise internal business clients on the corresponding impact upon Aetna's business, products, and services.
- Conduct legal research, translate legal/business requirements into plain language, and document and distribute legal summaries and recommendations for internal business clients.
- Review and draft legal correspondence, contracts, regulatory submissions, and other legal documents.
- Establish and maintain constructive regulatory relationships and represent Aetna in proceedings with state insurance, HMO, and Medicaid regulators.
- Draft and review legal correspondence, contracts, regulatory submissions, and other legal documents.
- Serve as a resource to other lawyers in the Law Department with respect to laws and regulations in California and certain other states.
- Protect and promote the interests of Aetna, its customers, and shareholders.
- Collaborate with other subject matter experts, including Product Counsel, Government Affairs, Privacy, and Regulatory Compliance.
- Oversee and manage outside counsel on state administrative charges, demand letters, and other claims/allegations to ensure high-quality, cost-effective service.
- Manage and coach direct-report regulatory-affairs professional to ensure timely, complete, and high-quality filings and related communications with California regulators (e.g., Knox-Keene submissions with the California DMHC), and to assist with resolution of any subsequent regulator objections/concerns.
Qualifications
In order to be successful in this role, the Senior Counsel must exhibit the following:
- Experience with applicable state insurance and managed-care laws and regulations, including California Knox-Keene Act experience and experience in the Medicaid area.
- Demonstrated working knowledge of other laws governing health care and health insurance.
Pay Range
The typical pay range for this role is:
Minimum: 157,800
Maximum: 347,200
Please keep in mind that this range represents the pay range for all positions in the job grade within which this position falls. The actual salary offer will take into account a wide range of factors, including location.
Required Qualifications
8+ years of legal experience with a law firm or healthcare company.
Admitted to practice law in California and member in good standing of applicable state bar association(s).
COVID Requirements
COVID-19 Vaccination Requirement
CVS Health requires certain colleagues to be fully vaccinated against COVID-19 (including any booster shots if required), where allowable under the law, unless they are approved for a reasonable accommodation based on disability, medical condition, religious belief, or other legally recognized reasons that prevents them from being vaccinated.
You are required to have received at least one COVID-19 shot prior to your first day of employment and to provide proof of your vaccination status or apply for a reasonable accommodation within the first 10 days of your employment. Please note that in some states and roles, you may be required to provide proof of full vaccination or an approved reasonable accommodation before you can begin to actively work.
Preferred Qualifications
High level of interpersonal skills and diplomatic finesse and strong written and verbal communication skills.
Legal acumen, solid legal and business judgment, and strong drafting, analytical, and problem-solving skills.
Have or able to quickly develop an understanding of Aetna's products and services.
Education
Juris Doctor (J.D.)
Business Overview
Bring your heart to CVS Health
Every one of us at CVS Health shares a single, clear purpose: Bringing our heart to every moment of your health. This purpose guides our commitment to deliver enhanced human-centric health care for a rapidly changing world. Anchored in our brand - with heart at its center - our purpose sends a personal message that how we deliver our services is just as important as what we deliver.
Our Heart At Work Behaviors support this purpose. We want everyone who works at CVS Health to feel empowered by the role they play in transforming our culture and accelerating our ability to innovate and deliver solutions to make health care more personal, convenient and affordable.
We strive to promote and sustain a culture of diversity, inclusion and belonging every day.
CVS Health is an affirmative action employer, and is an equal opportunity employer, as are the physician-owned businesses for which CVS Health provides management services. We do not discriminate in recruiting, hiring, promotion, or any other personnel action based on race, ethnicity, color, national origin, sex/gender, sexual orientation, gender identity or expression, religion, age, disability, protected veteran status, or any other characteristic protected by applicable federal, state, or local law.
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