Corporate Counsel

Who we are Founded in 1999 and headquartered in Central Ohio, we’re a privately-owned, independent healthcare navigation organization. We believe that no one should have to navigate the cost and complexity of healthcare alone, and we’re on a mission to make healthcare simpler and more effective for our millions of members. Our big-hearted, tech-savvy team fights to ensure that our members get the care they need, when they need it, at the most affordable cost – that’s why we call ourselves Healthcare Warriors®. We’re committed to building diverse and inclusive teams – more than 2,000 of us and counting – so if you’re excited about this position, we encourage you to apply – even if your experience doesn’t match every requirement.  

About the Role The Corporate Counsel – Benefits Administration & Service Contracts serves as a trusted legal advisor on matters related to employer-sponsored group health plan administration, including ERISA, ACA, MHPAEA, Medicare, state insurance law, HIPAA compliance, fiduciary governance, and contract negotiation involving health plan sponsors and downstream vendor service agreements. This role provides first-level legal support for operational compliance matters related to utilization management programs, wellness program incentive administration, claims and appeals support, and clinical excellence initiatives. The position also partners with cross-functional stakeholders to negotiate complex client and vendor contracts. The ideal candidate will bring extensive experience in group health plan design, appeals and disclosure requirements, and a strong understanding of the health plan industry. Location: This position may be performed remotely anywhere within the United States or in a hybrid capacity from the Dublin, Ohio office. What You'll Do (Essential Responsibilities) Negotiate and draft client, vendor, and partner contracts, including agreements with third-party administrators (TPAs), pharmacy benefit managers (PBMs), wellness vendors, stop-loss carriers, point solutions, and insurance providers Provide legal counsel on the design, implementation, and administration of health and welfare benefit plans, including medical, dental, vision, EAP, wellness, and flexible spending account (FSA) programs Ensure compliance with applicable laws and regulations, including ERISA, HIPAA, ACA, COBRA, and relevant state insurance requirements Draft, review, and maintain plan documents, Summary Plan Descriptions (SPDs), and participant communications to ensure regulatory compliance and clarity Respond to and resolve benefits-related disputes, claims, and appeals, including oversight of outside counsel when necessary Monitor legislative and regulatory developments impacting health and welfare benefits and implement updates to policies, procedures, and practices Support internal and external audits, Department of Labor investigations, and inquiries related to benefits administration and vendor contracts Provide education and training to internal stakeholders regarding fiduciary obligations, plan administration, and contract compliance requirements Participate in special projects and additional legal initiatives as assigned Perform other duties as assigned What You'll Bring (Qualifications) Juris Doctor (J.D.) degree from an accredited law school Active license to practice law in a U.S. state 5 to 10 years of legal experience, including significant expertise in health and welfare benefits, ERISA fiduciary matters, and vendor contract negotiation and management In-house counsel experience focused on employee benefits and health plans strongly preferred Benefits litigation experience preferred Deep knowledge of ERISA, HIPAA, ACA, COBRA, IRS regulations, and other laws affecting group health plans and employee benefits Strong understanding of fiduciary responsibilities under ERISA Demonstrated success negotiating and managing client and vendor contracts, including performance metrics and compliance obligations Ability to analyze complex legal issues and communicate recommendations clearly and effectively to business leaders Exceptional legal drafting, communication, and negotiation skills Strategic mindset with a practical, business-focused approach to legal problem-solving Ability to thrive in a fast-paced, cross-functional environment with competing priorities Strong technical proficiency with Microsoft Office applications, including Outlook, Word, Excel, and PowerPoint, as well as collaboration platforms such as Teams and Zoom Experience with Ironclad contract management software preferred High level of personal accountability, integrity, and commitment to organizational values, ethics, and data privacy requirements --    #LI-CH1 #LI-Remote