To provide legal advice and counsel to corporate officers, managers and employees of the Corporation and its various lines of business. Under the general direction of the General Counsel or Associate General Counsel, this individual provides direction and legal counsel to the Corporation and its subsidiaries, affiliates, and joint ventures. May advise on contracts, provider networks and credentialing, litigation, regulatory issues, risk management, operational issues, human resources issues, etc. Will have primary subject matter expert responsibility for one or more business units or shared services functions.

1. Provide seasoned legal assistance in the following areas as applicable to the individual's area of responsibility (specific services may vary depending on expertise and specialty; e.g., litigation, regulatory, contracting, public sector, labor and employment) :

- Contracting, including, but not limited to (as applicable), developing, reviewing and negotiating complex legal transactions and deals on behalf of the Corporation or related entities, customer contracts, provider agreements, vendor contracts, Strategic alliance agreements, licensing agreements, leases, recruiting and placement contracts, consulting agreements, physician advisor agreements and human resources contracts and agreements;

- Resolving complex legal statutory and regulatory issues, and collaborating with management to take appropriate actions to minimize legal risk throughout the Corporation;

- Credentialing, peer review and network provider issues, including, but not limited to, network development and contracting, network adequacy issues, reviewing adverse legal actions reported to the Corporation and submitted by providers during the credentialing process, providing guidance in the investigation of complaints against providers, participating in provider network status appeals, providing advice related to provider performance and contract issues, providing advice for inquiries that may result in changes in a provider's network status, termination of providers, and reporting requirements;

- Litigation management, including management of outside counsel handling the Corporation's litigation and government investigations, advising the Corporation's management regarding litigation risks, selection and engagement of outside counsel, direction of settlement negotiations and strategy in litigation and claims, and review and approval of outside counsel invoices;

- Providing legal oversight, direction and/or counsel for the Corporation's shared services functions, including matters relating to provider network, human resources, purchasing, intellectual property, finance, health care claims, corporate security and special investigations, member and provider complaints, and facilities.

- Advising corporate business units, including Care Management Centers, on operational issues including, but not limited to, quality of care, informed consent, termination of care, continuity of care, regulatory and statutory compliance, appeals of adverse decisions, complaints, claims and balance billing;

- Collaborating with Corporation shared services functions and business units to develop and promote operational ?best practices? in an effort to reduce the Corporation's legal risk;

- Reviewing and revising corporate policies and procedures, including identifying problem areas in existing policies and procedures and areas needing to be filled;

- Working directly with corporate counsel of customers to coordinate resolution of issues or address shared areas of legal risk;

- Reviewing and revising customer, provider and member communications;

- Risk management and insurance issues;

2. Review, evaluate and render legal determinations concerning internal programs or projects, customer requests, and the implementation of state and federal government-mandated requirements.

3. Review inquiries/complaints from state and federal administrative, regulatory and other governmental agencies, performing necessary research of the law and internal practices, coordinating, drafting, and negotiating the response and/or reviewing responses to the government agency and/or customer.
4.    Represent the Corporation before state and federal regulators and other constituencies such as provider associations.

SCOPE OF POSITION
- The responsibilities of this position require the individual to research, evaluate, interpret and resolve complex problems, and to function as a leader in driving execution and results in the individual's assigned function.
- The individual is responsible for guiding and advising corporate officers and managers to ensure they are fully aware of the legal ramifications of their actions and decision, advising them as to the proper and controlling legal requirements or precedents, and providing legally sound and practical, results-oriented, advice and recommendations to resolve business problems.
- This position impacts corporate programs and established policy through participation as legal advisor and, as appropriate, leader on committees developing/implementing policies, programs and projects.
- The individual in this position must remain current with legal issues affecting the Corporation and the health care industry.  The individual must ensure that, in the event of litigation, the appropriate documents, contracts and agreements are properly prepared and executed and that competent and knowledgeable staff is involved in the process.
- The individual acts within corporate policies and guidelines, and according to the tenets of behavior of the legal profession.
- Key internal contacts include all levels of staff and management regarding legal implications of business activity.  Key external contacts include communication with attorneys, the courts, customers (e.g., contracted Blue Cross plans), enrolled groups, subscribers, and states and federal government regulators.

The job duties listed above are representative and not intended to be all-inclusive of what may be expected of an employee assigned to this job. A leader may assign additional or other duties which would align with the intent of this job, without revision to the job description.

Other Job Requirements

Responsibilities

Admitted to practice law in at least one state.
Excellent written and verbal communications/advocacy skills, ability to work independently, ability to fashion practical business solutions to complex legal situations, negotiation skills.
General knowledge of the behavioral health care industry and regulatory environment.
5+ years of legal experience in healthcare industry.
8+ years of experience in a law firm, corporate or government setting practicing in a legal specialty area of relevance to the operations and functions and business of Magellan.

General Job Information

Title

Senior Legal Counsel I

Grade

32

Work Experience - Required

Healthcare, Legal

Work Experience - Preferred

Education - Required

JD - Law

Education - Preferred

License and Certifications - Required

License and Certifications - Preferred

Salary Range

Salary Minimum:

$127,295

Salary Maximum:

$229,105

This information reflects the anticipated base salary range for this position based on current national data. Minimums and maximums may vary based on location. Actual pay will be adjusted based on an individual's skills, experience, education, and other job-related factors permitted by law.

This position may be eligible for short-term incentives as well as a comprehensive benefits package. Magellan offers a broad range of health, life, voluntary and other benefits and perks that enhance your physical, mental, emotional and financial wellbeing.

Magellan Health, Inc. is proud to be an Equal Opportunity Employer and a Tobacco-free workplace. EOE/M/F/Vet/Disabled.
Every employee must understand, comply with and attest to the security responsibilities and security controls unique to their position; and comply with all applicable legal, regulatory, and contractual requirements and internal policies and procedures.