Healthcare Counsel (Personal Services)

Counsel will be a key member of the Evernorth business law team, serving as a legal advisor to the Care Solutions business within Evernorth. The Counsel will provide practical legal advice to key business leaders within Care Solutions on a wide array of healthcare issues across the behavioral, medical, and pharmacy benefits including, but not limited to, network contracting, client contracting, product development, go-to-market strategy, intercompany contracting, and regulatory matters.

This role requires seasoned judgment, significant healthcare transactional 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 Evernorth's business, integrated solutions, and pricing models and develop the ability to provide counsel to support novel and complex contract arrangements and product offerings.

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 Operations. 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 mental health parity, network contracting, utilization management, third party administrators, risk-bearing or capitated arrangements, and federal and state privacy laws and regulations (including the HIPAA Privacy Rule).

Key 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 Care Solutions product suite;
• Responsible for negotiating, drafting, and, when appropriate, approving the legal and business terms of Care Solution'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;
• End-to-end legal support of product development and go-to-market initiatives;
• Legal support for network contracting and network management of behavioral health providers;
• 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.

Qualifications:

• Juris Doctor required.
• This is a junior level role , 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.
• Familiarity with concepts, practices, and procedures related to the managed care industry is preferred.
• Ability to understand complex operations, technological, and financial issues related to Care Solution'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 risk with the need to achieve business goals.
• Identifies and researches legal issues pertinent to Evernorth and its interests, and assists in the development of clear recommendations regarding Evernorth'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.
• Strong, independent decision-making ability - leads by example.
• 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.
• **This is a flex role, in the office 3 days a week with 2 days at home.

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.

About The Cigna Group

Doing something meaningful starts with a simple decision, a commitment to changing lives. At The Cigna Group, we're dedicated to improving the health and vitality of those we serve. Through our divisions Cigna Healthcare and Evernorth Health Services, we are committed to enhancing the lives of our clients, customers and patients. Join us in driving growth and improving lives.

Qualified applicants will be considered without regard to race, color, age, disability, sex, childbirth (including pregnancy) or related medical conditions including but not limited to lactation, sexual orientation, gender identity or expression, veteran or military status, religion, national origin, ancestry, marital or familial status, genetic information, status with regard to public assistance, citizenship status or any other characteristic protected by applicable equal employment opportunity laws.

If you require reasonable accommodation in completing the online application process, please email: SeeYourself@cigna.com for support. Do not email SeeYourself@cigna.com for an update on your application or to provide your resume as you will not receive a response.

The Cigna Group has a tobacco-free policy and reserves the right not to hire tobacco/nicotine users in states where that is legally permissible. Candidates in such states who use tobacco/nicotine will not be considered for employment unless they enter a qualifying smoking cessation program prior to the start of their employment. These states include: Alabama, Alaska, Arizona, Arkansas, Delaware, Florida, Georgia, Hawaii, Idaho, Iowa, Kansas, Maryland, Massachusetts, Michigan, Nebraska, Ohio, Pennsylvania, Texas, Utah, Vermont, and Washington State.