Senior Managing Counsel, (Senior Director)

Cigna's Government Business Segment is a dynamic, fast-growing business that serves over 4 million customers in Medicare Advantage (including Employer Group Waiver Plans (EGWPs), Part D, Medicaid, ACA Exchange Plans and Medicare Supplement products across the United States. Cigna Legal seeks an experienced attorney to serve as Senior Counsel to provide strategic advice and counsel to the Medicare Advantage Government Business Segment. The position requires a deep understanding of federal healthcare programs, specifically Medicare, including federal and state laws and regulations unique to the health care industry and the application of those laws to business arrangements in the Medicare Advantage health plan.

In a highly-complex and evolving regulatory environment, the ideal candidate will provide actionable legal advice on health plan operations, governmental audits, compliance, regulator communications and other risk management issues; serve as a strategic partner in developing adaptive strategies, and effectively manage a high volume of matters.

Candidate must demonstrate strong listening, influencing and interpersonal skills with business clients and enterprise colleagues to foster collaboration across businesses and functions to drive results.

Responsibilities:

• Lead team of business attorneys responsible for government business regulatory support.
• Provide strategic, actionable legal regulatory advice and counsel to Cigna Government Business Segment products and services on Medicare Advantage, EGWP, Individual Family Plans, MedSupp and D-SNP programs.
• Provide interpretative and practical advice regarding oversight and compliance requirements of the Medicare Advantage and D-SNP programs.
• Advise Cigna Government Business Segment on compliance and risk mitigation; medical loss ratio and other financial and reporting requirements; Medicare Advantage bids and expansion efforts; and value-based arrangements.
• Serve as subject matter expert on federal health care laws and regulation, regulatory and enforcement environment affecting the business, including federal and state anti-kickback and self-referral laws, fraud and abuse, False Claims Act liability, government payor billing and reimbursement requirements and payment, government audits and audit readiness, Medicare sales and marketing rules and regulations and compliance programs.
• Serve as a strategic advisor and thought leader to internal clients to achieve enterprise goals while ensuring the highest degree of compliance.
• Advises on the development of business arrangements, including intercompany agreements, to assure compliance with CMS bid rules, federal and state fraud and abuse laws, including managed care and group purchasing organizations safe harbors
• Prepare executive facing analysis and risk assessments for internal clients.
• Collaborates strategically with the business team and enterprise colleagues on the impact and response to proposed and new rules, regulations and legislation.
• Assess, develop and communicate potential legal or compliance risks, including risk mitigation strategies.
• Work closely with business Operations, Finance, Clinical, Government Affairs and Compliance to identify and reduce known and potential regulatory, legal and business risks.
• Design and implement actionable and strategic measures to avoid, reduce and mitigate risks.

Qualifications:

• J.D. from accredited law school/Bar membership required
• At least 10 years in managed care organization or law firm healthcare experience. Experience in government programs and Medicare is strongly preferred.
• Experience leading teams preferred.
• Broad knowledge of federal health care programs and health plan operations.
• Strong analytical, written and oral communication skills, including negotiation skills.
• Interpersonal skills to develop and manage relationships with business clients at all levels
• Demonstrated track record of success in a highly matrixed environment.
• Strong ability to identify issues and propose actionable legal and business solutions.
• Uses a customer-focused and creative approach to problem solving and the ability to efficiently manage a substantial number of issues and competing priorities effectively.
• Strong ability to maneuver through business barriers to facilitate solutions.
• Exceptional track record of project, process and knowledge management.
• Strong work ethic with effective time-management
• Demonstrated good judgment and willingness to take on difficult projects.
• Experience in measuring and analyzing process, as well as results, to identify opportunities for improvement.
• Location: strongly prefer this role to be located in one of our major hubs, including but not limited to: Nashville, Bloomfield, St. Louis, Phoenix, Denver, Chicago, New York

If you will be working at home occasionally or permanently, the internet connection must be obtained through a cable broadband or fiber optic internet service provider with speeds of at least 10Mbps download/5Mbps upload.

About The Cigna Group

Doing something meaningful starts with a simple decision, a commitment to changing lives. At The Cigna Group, we're dedicated to improving the health and vitality of those we serve. Through our divisions Cigna Healthcare and Evernorth Health Services, we are committed to enhancing the lives of our clients, customers and patients. Join us in driving growth and improving lives.

Qualified applicants will be considered without regard to race, color, age, disability, sex, childbirth (including pregnancy) or related medical conditions including but not limited to lactation, sexual orientation, gender identity or expression, veteran or military status, religion, national origin, ancestry, marital or familial status, genetic information, status with regard to public assistance, citizenship status or any other characteristic protected by applicable equal employment opportunity laws.

If you require reasonable accommodation in completing the online application process, please email: [email protected] for support. Do not email [email protected] for an update on your application or to provide your resume as you will not receive a response.

The Cigna Group has a tobacco-free policy and reserves the right not to hire tobacco/nicotine users in states where that is legally permissible. Candidates in such states who use tobacco/nicotine will not be considered for employment unless they enter a qualifying smoking cessation program prior to the start of their employment. These states include: Alabama, Alaska, Arizona, Arkansas, Delaware, Florida, Georgia, Hawaii, Idaho, Iowa, Kansas, Maryland, Massachusetts, Michigan, Nebraska, Ohio, Pennsylvania, Texas, Utah, Vermont, and Washington State.