Counsel

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Counsel
Duties: The candidate will operate as a thought partner and collaborate with business leaders and other internal professionals, including those in Sales and Product; Compliance; Government Affairs; Enterprise Risk Management; and Services & Solutions. Must gain an understanding of applicable state and federal laws and regulations, including laws pertaining to utilization management, third-party administrators, risk-bearing or capitated arrangements, and federal and state privacy laws and regulations (including the HIPAA Privacy Rule). Responsible for negotiating and drafting the business terms and negotiation, drafting, and approving the legal and business terms of eviCore’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. 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.

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