Corporate Counsel

Description

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, but not limited to ERISA, ACA, MHPAEA, Medicare, state insurance law and HIPAA compliance, fiduciary governance, and general contract negotiation as a service provider to group health plan sponsors and downstream vendor service agreements.


This role supports the legal team providing first-level support for operational compliance issues related to utilization management programs, wellness program incentive management, claim and appeal administration support, and clinical excellence in addition to negotiating complex client and downstream vendor service contracts in partnership with cross-functional stakeholders. The ideal candidate will bring broad experience in group health plan design, appeal letter drafting, reporting and disclosure obligations, and a deep knowledge of the health plan industry.


Location: This position may work remotely anywhere in the United States of America or may work hybrid from our Dublin, Ohio location.


What you'll do (Essential Responsibilities)

• Negotiate and draft client and downstream vendor contracts, as well as contracts with third-party administrators (TPAs), pharmacy benefit managers (PBMs), wellness vendors, stop-loss carriers, point solutions, and insurers.
• Provide strategic counsel on the design, implementation, and administration of health and welfare benefit plans, including medical, dental, vision, EAP, wellness, and flexible spending accounts (FSAs).
• Ensure compliance with all applicable laws and regulations, including ERISA, HIPAA, ACA, COBRA, and relevant state insurance laws.
• Draft, review, and maintain plan documents, summary plan descriptions (SPDs), and related participant communications to ensure regulatory compliance and clarity.
• Respond to and resolve benefits-related disputes, claims, and appeals, including oversight of external counsel when necessary.
• Monitor and interpret legislative and regulatory developments affecting health and welfare benefits and implement timely updates to policies and practices.
• Assist in internal and external audits, DOL investigations, or inquiries related to benefits or vendor contracts.
• Provide education and training to internal stakeholders on fiduciary obligations, plan administration, and contract compliance.
• Perform additional duties and special projects as assigned.
• Other duties as assigned

What you'll bring (Qualifications)

• Education: Juris Doctor (J.D.) from an accredited law school.
• Licensure/Certifications: Current and active license to practice law in a U.S. state.
• Experience: 5-10 years of legal experience, with significant expertise in health and welfare benefits, ERISA fiduciary matters, and vendor contract negotiation and management.
  • In-house counsel experience with a focus on employee benefits and health plans strongly preferred.
  • Benefit litigation experience would be a strong plus.
  • Deep knowledge of ERISA, HIPAA, ACA, COBRA, IRS regulations, and other laws impacting group health plans and employee benefits.
• Strong understanding of fiduciary responsibilities under ERISA.
• Demonstrated success managing and negotiating client and partner contracts, including performance metrics and compliance terms.
• Ability to analyze and explain complex legal concepts clearly and concisely to business leaders.
• Exceptional drafting, communication, and negotiation skills.
• Strategic thinker with a pragmatic, business-oriented approach to legal problem-solving.
• Comfortable working in fast-paced, cross-functional environments with competing priorities.
• Strong administrative/technical skills; Comfort working on a PC using Microsoft Office (Outlook, Word, Excel, PowerPoint), IM/video conferencing (Teams & Zoom), and telephones efficiently.
• Experience with Ironclad contract management software a plus.
• Strong personal accountability, integrity, a commitment to upholding Quantum Health's values, ethics, and data privacy requirements.

#LI-AT1

#LI-Remote

What's in it for you

• Compensation: Competitive base and incentive compensation
• Coverage: Health, vision and dental featuring our best-in-class healthcare navigation services, along with life insurance, legal and identity protection, adoption assistance, EAP, Teladoc services and more.
• Retirement: 401(k) plan with up to 4% employer match and full vesting on day one.
• Balance: Paid Time Off (PTO), 7 paid holidays, parental leave, volunteer days, paid sabbaticals, and more.
• Development: Tuition reimbursement up to $5,250 annually, certification/continuing education reimbursement, discounted higher education partnerships, paid trainings and leadership development.
• Culture: Recognition as a Best Place to Work for 15+ years, dedication to diversity, philanthropy and sustainability, and people-first values that drive every decision.
• Environment: A modern workplace with a casual dress code, open floor plans, full-service dining, free snacks and drinks, complimentary 24/7 fitness center with group classes, outdoor walking paths, game room, notary and dry-cleaning services and more!

What you should know

• Internal Associates: Already a Healthcare Warrior? Apply internally through Jobvite.
• Process: Application > Phone Screen > Online Assessment(s) > Interview(s) > Offer > Background Check.
• Diversity, Equity and Inclusion: Quantum Health welcomes everyone. We value our diverse team and suppliers, we're committed to empowering our ERGs, and we're proud to be an equal opportunity employer .
• Tobacco-Free Campus: To further enable the health and wellbeing of our associates and community, Quantum Health maintains a tobacco-free environment. The use of all types of tobacco products is prohibited in all company facilities and on all company grounds.
• Compensation Ranges: Compensation details published by job boards are estimates and not verified by Quantum Health. Details surrounding compensation will be disclosed throughout the interview process. Compensation offered is based on the candidate's unique combination of experience and qualifications related to the position.
• Sponsorship: Applicants must be legally authorized to work in the United States on a permanent and ongoing future basis without requiring sponsorship.
• Agencies: Quantum Health does not accept unsolicited resumes or outreach from third-parties. Absent a signed MSA and request/approval from Talent Acquisition to submit candidates for a specific requisition, we will not approve payment to any third party.

Reasonable Accommodation: Should you require reasonable accommodation(s) to participate in the application/interview/selection process, or in order to complete the essential duties of the position upon acceptance of a job offer, click here to submit a recruitment accommodation request.

California Employee and Job Applicant Notice of Collection of Personal Information: If you are a California resident, Quantum Health may collect personal information in connection with your application for employment and, if hired, during the course of your employment. The categories of personal information collected and the purposes for which that information is used are described in our California Employee and Job Applicant Notice of Collection of Personal Information. Please review the notice here:
California Employee and Job Applicant Notice

Recruiting Scams: Unfortunately, scams targeting job seekers are common. To protect our candidates, we want to remind you that authorized representatives of Quantum Health will only contact you from an email address ending in @quantum-health.com. Quantum Health will never ask for personally identifiable information such as Date of Birth (DOB), Social Security Number (SSN), banking/direct/tax details, etc. via email or any other non-secure system, nor will we instruct you to make any purchases related to your employment. If you believe you've encountered a recruiting scam, report it to the Federal Trade Commission and your state's Attorney General.