Job Description

Anticipated End Date:

2026-06-22

Position Title:

Legal Counsel Senior - Medicaid

Legal Counsel Senior - Medicaid

Location: This role requires associates to be in-office 3 days per week, fostering collaboration and connectivity, while providing flexibility to support productivity and work-life balance. This approach combines structured office engagement with the autonomy of virtual work, promoting a dynamic and adaptable workplace. Alternate locations may be considered if candidates reside within a commuting distance from an office.

Please note that per our policy on hybrid/virtual work, candidates not within a reasonable commuting distance from the posting location(s) will not be considered for employment, unless an accommodation is granted as required by law.

The Legal Counsel Senior is responsible for completing a variety of routine and non-routine Medicaid legal assignments and intermediate level projects independently and using professional legal concepts and principles in accordance with company and departmental objectives to solve challenging, or legal issues in practical ways. Works autonomously with regular collaboration and reporting to management. At this level the associate has developed a specific technical depth and/or breadth of organizational and industry legal issues.

How you will make an impact:

• Leads legal strategy and support for Medicaid State Fair Hearing matters across all Medicaid markets.
• Advises internal business partners on federal and state Medicaid hearing requirements, manages hearing preparation and representation, develops enterprise standards and best practices, supports risk mitigation and remediation, and partners with market, clinical, compliance, regulatory, and operations teams to ensure timely, consistent, and legally sound handling of member hearing matters.
• Coordinates with and oversees outside counsel to ensure appropriate staffing, preparation, and support of all Medicaid State Fair Hearings
• Oversees development of quarterly Medicaid State Fair Hearing reporting, interprets report results, identifies legal and operational trends, and independently drives recommended actions to reduce risk, improve processes, and reduce avoidable hearing volume.
• Works with more experienced attorneys to represent the organization in legal duties associated with serving as legal counsel for one or more Medicaid markets.
• May research legal principles and precedents, consult with outside counsel, draft and execute legal documents, gather relevant case related information using multiple sources and methods.
• Contributes to overall results of an SBU or CEE unit and/or department.
• Serves as a strategic partner with assigned clients.
• Provides legal solutions to a wide range of difficult or new problems.
• Develops recommendations and solutions that are thorough, practical and consistent with organizational objectives.
• May support the development of other attorneys and paralegals by providing guidance on technical and tactical procedures for lower level attorneys.
• Assesses and mitigates risk for familiar situations.
• Reports to management any identified business exposure and associated risks as well as mitigation techniques being utilized.

Minimum Requirements:

Requires a JD, current license to practice law, and a minimum of 6 years of specific industry and/or technical legal experience post licensure; or any combination of education and experience, which would provide an equivalent background.

Preferred Skills, Capabilities and Experiences:

• Prior litigation, administrative hearing, or administrative law experience, with demonstrated ability to develop hearing strategy, prepare witnesses and evidence, manage outside counsel or internal stakeholders, and support or lead Medicaid State Fair Hearing proceedings across multiple jurisdictions preferred.
• Experience with Medicaid managed care programs preferred.
• Knowledge of federal Medicaid managed care regulations and familiarity with State Medicaid agency contracts preferred.
• Experience advising health plans, managed care organizations, Medicaid agencies, providers, or healthcare entities on regulatory, litigation, administrative, or compliance matters preferred.
• Experience managing high-volume, multi-jurisdictional matters or legal processes across multiple states or markets preferred.
• Experience managing outside counsel, paralegals, hearing representatives, or cross-functional project teams preferred.
• Strong ability to identify legal and operational risk trends, support remediation, and communicate effectively with senior leaders, regulators, hearing officers, clinicians, compliance teams, and operational stakeholders preferred.
• Experience developing enterprise policies, procedures, playbooks, templates, training, or governance processes preferred.
• Strong written and verbal advocacy skills, including the ability to explain complex legal, clinical, and operational issues clearly to hearing officers, regulators, business partners, and senior leaders preferred.
• Ability to interpret complex healthcare regulations in a practical, business-oriented manner preferred.

For candidates working in person or virtually in the below location(s), the salary* range for this specific position is $160,336 to $240,504.

Locations: Mendota Heights, MN; Chicago, IL

In addition to your salary, Elevance Health offers benefits such as, a comprehensive benefits package, incentive and recognition programs, equity stock purchase and 401k contribution (all benefits are subject to eligibility requirements). The salary offered for this specific position is based on a number of legitimate, non-discriminatory factors set by the Company. The Company is fully committed to ensuring equal pay opportunities for equal work regardless of gender, race, or any other category protected by federal, state, and local pay equity laws

* The salary range is the range Elevance Health in good faith believes is the range of possible compensation for this role at the time of this posting. This range may be modified in the future and actual compensation may vary from posting based on geographic location, work experience, education and/or skill level. Even within the range, the actual compensation will vary depending on the above factors as well as market/business considerations. No amount is considered to be wages or compensation until such amount is earned, vested, and determinable under the terms and conditions of the applicable policies and plans. The amount and availability of any bonus, commission, benefits, or any other form of compensation and benefits that are allocable to a particular employee remains in the Company's sole discretion unless and until paid and may be modified at the Company’s sole discretion, consistent with the law.

Job Level:

Director Equivalent

Workshift:

1st Shift (United States of America)

Job Family:

LEG > Attorneys

Please be advised that Elevance Health only accepts resumes for compensation from agencies that have a signed agreement with Elevance Health. Any unsolicited resumes, including those submitted to hiring managers, are deemed to be the property of Elevance Health.

Who We Are

Elevance Health is a health company dedicated to improving lives and communities – and making healthcare simpler. We are a Fortune 25 company with a longstanding history in the healthcare industry, looking for leaders at all levels of the organization who are passionate about making an impact on our members and the communities we serve.

How We Work

At Elevance Health, we are creating a culture that is designed to advance our strategy but will also lead to personal and professional growth for our associates. Our values and behaviors are the root of our culture. They are how we achieve our strategy, power our business outcomes and drive our shared success - for our consumers, our associates, our communities and our business.

We offer a range of market-competitive total rewards that include merit increases, paid holidays, Paid Time Off, and incentive bonus programs (unless covered by a collective bargaining agreement), medical, dental, vision, short and long term disability benefits, 401(k) +match, stock purchase plan, life insurance, wellness programs and financial education resources, to name a few.

Elevance Health operates in a Hybrid Workforce Strategy. Unless specified as primarily virtual by the hiring manager, associates are required to work at an Elevance Health location at least once per week, and potentially several times per week. Specific requirements and expectations for time onsite will be discussed as part of the hiring process.

The health of our associates and communities is a top priority for Elevance Health. We require all new candidates in certain patient/member-facing roles to become vaccinated against COVID-19 and Influenza. If you are not vaccinated, your offer will be rescinded unless you provide an acceptable explanation. Elevance Health will also follow all relevant federal, state and local laws.

Elevance Health is an Equal Employment Opportunity employer, and all qualified applicants will receive consideration for employment without regard to age, citizenship status, color, creed, disability, ethnicity, genetic information, gender (including gender identity and gender expression), marital status, national origin, race, religion, sex, sexual orientation, veteran status or any other status or condition protected by applicable federal, state, or local laws. Applicants who require accommodation to participate in the job application process should submit the following form: Accessibility Accommodation Request Form and a member of the team will be in contact. Qualified applicants with arrest or conviction records will be considered for employment in accordance with all federal, state, and local laws, including, but not limited to, the Los Angeles County Fair Chance Ordinance and the California Fair Chance Act.

Prospective employees required to be screened under Florida law should review the education and awareness resources at HB531 | Florida Agency for Health Care Administration

NOTE: Workday keeps job postings active through 11:59:59 PM on the day before the listed end date. Example: If the end date is 3/13, the posting will automatically come down on 3/12 at 11:59:59 PM. In other words — the job is posted until 3/13, not through 3/13.