Simply Healthcare Plans is a Florida managed health care provider that serves Medicare and Medicaid members. Through our Clear Health Alliance organization, our health plan also serves Floridians who are eligible for HIV/AIDS Medicaid specialty health plan services. Along with our sister plan, Amerigroup Florida, we serve more than 600,000 Floridians who are members of our Medicare and Medicaid plans. Across the nation, our family of health plans serve nearly 40 million members, and 1 in 8 Americans is served by our family of companies. Our health plan members are assured care that is not only accessible, but also accountable, comprehensive, integrated and patient-centered. Each and every day, members of our team can be found in Florida communities, listening to our members, interacting with our health care providers and partnering with community-based organizations to execute health education initiatives. Our goal is to ensure members and entire communities are empowered to become active participants in their health care and sustain healthy lifestyles. To learn more about Simply Healthcare Plans, visit www.simplyhealthcareplans.com .
This position will serve as the primary legal support for the entire Simply Healthcare Plans, Inc. – Medicare Business Unit.
Responsible for providing legal advice and recommendations for initiatives and projects developed in response to client’s 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.
Primary duties may include, but are not limited to:
Applies knowledge of one or more legal specialties with sound business acumen and knowledge of the business goals and objectives as they relate to the legal matter at hand.
Determines methods and procedures on new assignments and may coordinate legal projects.
Contributes to overall results of a unit and/or department.
Uses professional legal concepts and principles to contribute to development of company’s concepts and principles.
Provides concise, timely briefings to senior level business and legal management.
Routinely works on complex problems in which analysis of situations and/or facts require an in-depth evaluation of various facts.
Serves as a resource for other attorneys and paralegals as well as business clients instructing and advising on technical and tactical issues.
Assesses and mitigates risk. Reports to management any identified business exposure and associated risks as well as mitigation techniques being utilized.
Requires a JD and a current applicable license to practice law in Florida. 6-8 years of specific industry and/or technical legal experience post licensure; or any combination of education and experience, which would provide an equivalent background.
Requires effective communication skills as well as follow-up and organizational skills.
Requires Bilingual English-Spanish fluency both verbal and written.
Requires experience with Medicare Advantage laws and regulations.
Must have experience drafting and negotiating provider contracts, including risk based contracting arrangements.
Strong transactional and business counseling skills.
Medicare Supplemental Managed Care and Part D experience is preferred.
Experience with integrated delivery systems is also preferred.
Anthem, Inc. is ranked as one of America’s Most Admired Companies among health insurers by Fortune magazine and is a 2017 DiversityInc magazine Top 50 Company for Diversity. To learn more about our company and apply, please visit us at antheminc.com/careers. EOE. M/F/Disability/Veteran.
Website : http://www.antheminc.com
The company was formed when WellPoint Health Networks Inc. and Anthem, Inc. merged in 2004 to become the nation's leading health benefits company. The parent company originally assumed the WellPoint, Inc. name at the time of the merger. In December 2014, WellPoint, Inc. changed its corporate name to Anthem, Inc. The Anthem brand is built on a foundation of trust – it’s the name consumers are most familiar with as a trusted health care partner through our affiliated health plans. Anthem, Inc. is one of the largest health benefits companies in the United States. Through its affiliated health plans, Anthem companies deliver a number of leading health benefit solutions through a broad portfolio of integrated health care plans and related services, along with a wide range of specialty products such as life and disability insurance benefits, dental, vision, behavioral health benefit services, as well as long term care insurance and flexible spending accounts. Headquartered in Indianapolis, Indiana, Anthem, Inc. is an independent licensee of the Blue Cross and Blue Shield Association serving members in California, Colorado, Connecticut, Georgia, Indiana, Kentucky, Maine, Missouri, Nevada, New Hampshire, New York, Ohio, Virginia and Wisconsin; and specialty plan members in other states.