Senior Attorney Denver, Colorado, United States; New York, New York, United States; Remote
Judi Health is an enterprise health technology company providing a comprehensive suite of solutions for employers and health plans, including:Capital Rx , a public benefit corporation delivering full‐service pharmacy benefit management (PBM) solutions to self‐insured employers,Judi HealthTM , which offers full‐service health benefit management solutions to employers, TPAs, and health plans, andJudi , the industry's leading proprietary Enterprise Health Platform (EHP), which consolidates all claim administration‐related workflows in one scalable, secure platform.Together with our clients, we're rebuilding trust in healthcare in the U.S. and deploying the infrastructure we need for the care we deserve. To learn more, visit www.judi.health.Position DescriptionJudi Health is looking for a dynamic and experienced regulatory attorney, reporting directly to the General Counsel, to provide strategic legal advice to internal business partners with respect to healthcare regulations and laws. The successful candidate will identify legal and business risks and solutions that balance legal risks and business objectives. You will be expected to develop a keen understanding of the business and operational goals of the enterprise, develop and maintain positive relationships with clients at all levels of the organization, and provide practical and sound advice on legal issues related to business objectives and take an active role in driving projects to a result.Position ResponsibilitiesRegulatory Affairs & Change ManagementManage and provide legal oversight for regulatory change management for the Company, including monitoring, analyzing, and interpreting federal and state healthcare legislation, proposed legislation, and sub‐regulatory guidance.Track regulatory developments and assess their impact on organizational strategy, operations, and provider relationships.Provide practical, risk‐based legal advice to support regulatory change management initiatives, including implementation planning and cross‐functional execution.Develop and deliver clear legal guidance, summaries, and recommendations for senior leadership and business stakeholders.Support internal policy development and updates to ensure alignment with evolving regulatory requirements.Licensing & Credentialing OversightManage and provide legal oversight for organizational licensing activities, including initial applications, renewals, and compliance with state and federal requirements.Advise on licensing strategies related to provider expansion, new service lines, geographic growth, and organizational restructuring.Serve as a legal resource for licensing issues, audits, investigations, and correspondence with regulatory agencies.Provide legal support for provider relations contracting, including drafting, reviewing, and negotiating provider agreements and related amendments.Advise on regulatory compliance matters affecting provider contracts, reimbursement arrangements, and network participation.Collaborate with provider relations, contracting, and compliance teams to ensure contracts align with regulatory, operational, and business objectives.Partner with compliance, government affairs, operations, and business teams to proactively identify and mitigate legal and regulatory risks.Support other legal and regulatory initiatives as needed, including audits, investigations, and special projects.Maintain strong relationships with internal stakeholders and external counsel as appropriate.Responsible for adherence to the Capital Rx Code of Conduct, including reporting of non‐compliance.Required Qualifications8+ years legal attorney experience in a law firm and/or in‐house setting.In‐depth knowledge of healthcare laws, regulations and industry standards governing the provision of healthcare.Juris Doctorate Degree (JD) and admission to the bar in at least one state and in good standing with applicable bar association.Healthcare laws and regulations including HIPAA, Medicare, Medicaid, False Claims Act, or Federal Anti‐Kickback Statute.Excellent written and oral communication skills in a professional manner.Experience working with PBMs and related laws.Proven ability to thrive in a fast‐paced, performance‐driven culture.Demonstrated leadership initiative, resilience and ability to embrace change.Strong work ethic, be a self‐starter, and able to be highly productive in a dynamic, collaborative environment.Salary Range$115,000 – $260,000 USDAll employees are responsible for adherence to the Capital Rx Code of Conduct, including the reporting of non‐compliance. This position description is designed to be flexible, allowing management the opportunity to assign or re‐assign duties and responsibilities as needed to best meet organizational goals.Judi Health values a diverse workplace and celebrates the diversity that each employee brings to the table. We are proud to provide equal employment opportunities to all employees and applicants for employment and prohibit discrimination and harassment of any type without regard to race, color, religion, age, sex, national origin, disability status, medical condition, genetic information, protected veteran status, sexual orientation, gender identity or expression, or any other characteristic protected by federal, state or local laws.By submitting an application, you agree to the retention of your personal data for consideration for a future position at Judi Health. More details about Judi Health's privacy practices can be found at https://www.judi.health/legal/privacy-policy.#J-18808-Ljbffr