Associate General Counsel - Carelon Services

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Job Description:

Associate General Counsel Carelon Services

Location: This role requires associates to be in-office 3 days per week fostering collaboration and connectivity while providing flexibility to support productivity and work-life balance. This approach combines structured office engagement with the autonomy of virtual work promoting a dynamic and adaptable workplace. Alternate locations may be considered.

The Associate General Counsel - Carelon Services is responsible for providing legal advice and recommendations for initiatives and projects developed in response to clients overall objectives and needs. Focus of work is on large scale and/or high financial level projects with broad department and/or organizational impact and moderate level of risk. Works as a strategic partner and decision maker with more senior leaders and manages work independently.

How you will make an impact:

• Provide legal advice and counsel to business leadership on a wide range of health law regulatory contractual and operational matters impacting Carelon Services businesses including behavioral health medical benefits utilization management specialty care solutions and care delivery companies.

• Collaborate with internal subject matter experts within Elevances larger Legal Compliance and Public Affairs functions to provide comprehensive support and clear consolidated legal advice to the Carelon Services businesses.

• Guide assigned business partners through enterprise-level governance reviews relating to Artificial Intelligence Product Development Technology Governance and Regulatory Compliance.

• Work as a strategic partner with assigned clients and provide legal advice and guidance on business strategies or various corporate initiatives. Support the development of new products and services by evaluating legal and compliance risks and proposing mitigation strategies.

• Support value-based contracting and negotiation of shared savings or risk arrangements with strategic vendors and providers.

• Support the sales and growth function for assigned business units including support for public and private procurements and RFP processes.

• Provide sound legal advice to the business on pre-litigation dispute management.

• Works autonomously and manages work independently. Works autonomously and manages work independently. Escalates significant issues and risks as well as proposed mitigation options to business and legal leadership.

• May support the development of paralegals and legal specialists on the legal team.

• Light travel may be required.

Minimum Requirements:

Requires a JD current license to practice law and a minimum of 9 years of specific industry and/or technical legal experience post licensure; or any combination of education and experience which would provide an equivalent background.

Preferred Skills Capabilities and Experiences:

• Health Insurance Law: An understanding of the principles definitions and nuances within health insurance law preferred.

• Federal Regulations: Knowledge of federal laws that regulate health insurance companies including the ACA ERISA the No Surprises Act and other federal statutes impacting health insurance preferred.

• Expertise in legal and regulatory issues affecting utilization management activities including prior authorization medical necessity clinical policies and guideline development appeals and external review organization appeals preferred.

• Compliance: Understanding of regulatory compliance how to ensure adherence to laws regulations guidelines and specifications relevant to the health insurance and health care services business preferred.

• Contract Law: Experience interpreting drafting and reviewing health plan service contracts and managed care contracts. Experience with value-based care provider agreements and risk-bearing provider contracts preferred.

• Working knowledge of state laws and regulations that apply to health plan operations TPAs and utilization review agents preferred.

• Excellent communication skills and problem-solving competencies preferred.

For candidates working in person or virtually in the below location(s) the salary* range for this specific position is $187616 to $307008.

Locations: Illinois; New York.

In addition to your salary Elevance Health offers benefits such as a comprehensive benefits package incentive and recognition programs equity stock purchase and 401k contribution (all benefits are subject to eligibility requirements). The salary offered for this specific position is based on a number of legitimate non-discriminatory factors set by the Company. The Company is fully committed to ensuring equal pay opportunities for equal work regardless of gender race or any other category protected by federal state and local pay equity laws.

* The salary range is the range Elevance Health in good faith believes is the range of possible compensation for this role at the time of this posting. This range may be modified in the future and actual compensation may vary from posting based on geographic location work experience education and/or skill level. Even within the range the actual compensation will vary depending on the above factors as well as market/business considerations. No amount is considered to be wages or compensation until such amount is earned vested and determinable under the terms and conditions of the applicable policies and plans. The amount and availability of any bonus commission benefits or any other form of compensation and benefits that are allocable to a particular employee remains in the Companys sole discretion unless and until paid and may be modified at the Companys sole discretion consistent with the law.

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Please be advised that Elevance Health only accepts resumes for compensation from agencies that have a signed agreement with Elevance Health. Any unsolicited resumes including those submitted to hiring managers are deemed to be the property of Elevance Health.

Who We Are

Elevance Health is a health company dedicated to improving lives and communities and making healthcare simpler. We are a Fortune 25 company with a longstanding history in the healthcare industry looking for leaders at all levels of the organization who are passionate about making an impact on our members and the communities we serve.

How We Work

At Elevance Health we are creating a culture that is designed to advance our strategy but will also lead to personal and professional growth for our associates. Our values and behaviors are the root of our culture. They are how we achieve our strategy power our business outcomes and drive our shared success - for our consumers our associates our communities and our business.

We offer a range of market-competitive total rewards that include merit increases paid holidays Paid Time Off and incentive bonus programs (unless covered by a collective bargaining agreement) medical dental vision short and long term disability benefits 401(k) match stock purchase plan life insurance wellness programs and financial education resources to name a few.

Elevance Health operates in a Hybrid Workforce Strategy. Unless specified as primarily virtual by the hiring manager associates are required to work at an Elevance Health location at least once per week and potentially several times per week. Specific requirements and expectations for time onsite will be discussed as part of the hiring process.

The health of our associates and communities is a top priority for Elevance Health. We require all new candidates in certain patient/member-facing roles to become vaccinated against COVID-19 and Influenza. If you are not vaccinated your offer will be rescinded unless you provide an acceptable explanation. Elevance Health will also follow all relevant federal state and local laws.

Elevance Health is an Equal Employment Opportunity employer and all qualified applicants will receive consideration for employment without regard to age citizenship status color creed disability ethnicity genetic information gender (including gender identity and gender expression) marital status national origin race religion sex sexual orientation veteran status or any other status or condition protected by applicable federal state or local laws. Applicants who require accommodation to participate in the job application process may contact for assistance. Qualified applicants with arrest or conviction records will be considered for employment in accordance with all federal state and local laws including but not limited to the Los Angeles County Fair Chance Ordinance and the California Fair Chance Act.