Assistant General Counsel (Health Plan Operations)

TL;DR

Assistant General Counsel (Health Plan Operations): Providing practical, business-minded legal counsel for Medicare Advantage and related health plan operations with an accent on claims, provider contracting, and regulatory compliance. Focus on translating complex legal landscapes into actionable guidance for business and clinical teams while managing delegated entity oversight.

Location: Remote (USA)

Salary: $175,000–$225,000/year plus equity

Company

hirify.global is a mission-driven healthcare company using advanced data and AI to improve the well-being of older Americans through integrated care platforms.

What you will do

• Advise on claims adjudication, payment integrity, and appeals processes.
• Support provider contracting, network management, and credentialing operations.
• Ensure adherence to state and federal health care laws and regulatory requirements.
• Manage delegation arrangements with third-party vendors like TPAs and PBMs.
• Support regulatory exams, audits, and inquiries from state departments of insurance.
• Translate evolving regulatory guidance into actionable recommendations for clinical and business teams.

Requirements

• Licensed to practice law in at least one US state.
• 8–10 years of legal experience, including 2–4 years of in-house experience.
• Prior in-house experience at a health plan is required.
• Strong knowledge of health care regulatory requirements, including claims and provider contracting.
• Proven ability to manage complex issues and meet regulatory deadlines.
• Excellent interpersonal and communication skills with a proactive, solutions-oriented mindset.

Nice to have

• Prior in-house experience for a Medicare Advantage plan.

Culture & Benefits

• Employer-sponsored health, dental, and vision plans with low or no premiums.
• 401K program and stock options for all employees.
• Generous paid time off and parental leave program.
• $100 monthly mobile or internet stipend.
• Collaborative, mission-driven environment focused on member care.