Clinical Legal Advisor - Administrative Appeals
Lawyer Job In Montpelier, VT
**Become a part of our caring community and help us put health first** The Legal Advisor performs a variety of law-related tasks such as legal research, drafting legal documents and other related duties. The Legal Advisor works on problems of diverse scope and complexity ranging from moderate to substantial.
The Legal Advisor will support Humana's Law Department's representation of Humana in Medicare administrative appeals. Responsibilities will include reviewing appeal case files to determine the level of clinical support needed for administrative law judge (ALJ) hearings, providing testimony at ALJ hearings, preparing clinical arguments and position summaries in connection with administrative appeals, and supporting the identification of trends and data monitoring impacting ALJ hearings. The Legal Advisor will also be expected to advise executives to develop functional strategies on matters of significance; exercise independent judgment and decision making on complex issues regarding job duties and related tasks, work under minimal supervision, and uses independent judgment requiring analysis of variable factors and determining the best course of action.
**Use your skills to make an impact**
**Required Qualifications**
+ Bachelor's degree
+ Active Nursing or other Clinical License
+ Effective interpersonal, teaming and communication
+ Proficiency with Microsoft Office programs (emphasis in Word, Excel, and PowerPoint), Adobe Professional
+ Excellent research and writing skills
+ Proven organizational skills, as well as flexibility, and ability to manage multiple or competing priorities within designated time frames and adjust priorities in a fast-paced environment
+ Must be passionate about contributing to an organization focused on continuously improving consumer experiences
**Preferred Qualifications**
+ Paralegal experience
+ Corporate law or compliance department or law firm paralegal experience preferably with experience in medical or Medicare/Medicaid insurance
+ Experience involving the Medicare administrative appeals process
**Scheduled Weekly Hours**
40
**Pay Range**
The compensation range below reflects a good faith estimate of starting base pay for full time (40 hours per week) employment at the time of posting. The pay range may be higher or lower based on geographic location and individual pay will vary based on demonstrated job related skills, knowledge, experience, education, certifications, etc.
$104,000 - $143,000 per year
This job is eligible for a bonus incentive plan. This incentive opportunity is based upon company and/or individual performance.
**Description of Benefits**
Humana, Inc. and its affiliated subsidiaries (collectively, "Humana") offers competitive benefits that support whole-person well-being. Associate benefits are designed to encourage personal wellness and smart healthcare decisions for you and your family while also knowing your life extends outside of work. Among our benefits, Humana provides medical, dental and vision benefits, 401(k) retirement savings plan, time off (including paid time off, company and personal holidays, volunteer time off, paid parental and caregiver leave), short-term and long-term disability, life insurance and many other opportunities.
Application Deadline: 06-30-2025
**About us**
Humana Inc. (NYSE: HUM) is committed to putting health first - for our teammates, our customers and our company. Through our Humana insurance services and CenterWell healthcare services, we make it easier for the millions of people we serve to achieve their best health - delivering the care and service they need, when they need it. These efforts are leading to a better quality of life for people with Medicare, Medicaid, families, individuals, military service personnel, and communities at large.
**Equal Opportunity Employer**
It is the policy of Humana not to discriminate against any employee or applicant for employment because of race, color, religion, sex, sexual orientation, gender identity, national origin, age, marital status, genetic information, disability or veteran status. It is also the policy of Humana to take affirmative action to employ and to advance in employment, all persons regardless of race, color, religion, sex, sexual orientation, gender identity, national origin, age, marital status, genetic information, disability or protected veteran status, and to base all employment decisions only on valid job requirements. This policy shall apply to all employment actions, including but not limited to recruitment, hiring, upgrading, promotion, transfer, demotion, layoff, recall, termination, rates of pay or other forms of compensation and selection for training, including apprenticeship, at all levels of employment.
Humana complies with all applicable federal civil rights laws and does not discriminate on the basis of race, color, national origin, age, disability, sex, sexual orientation, gender identity or religion. We also provide free language interpreter services. See our ***************************************************************************
Intellectual Property Counsel
Lawyer Job In Montpelier, VT
Public Consulting Group LLC (PCG) is a leading public sector solutions implementation and operations improvement firm that partners with health, education, and human services agencies to improve lives. Founded in 1986, PCG employs approximately 2,000 professionals throughout the U.S.-all committed to delivering solutions that change lives for the better. The firm is a member of a family of companies with experience in all 50 states, and clients in three Canadian provinces and Europe. PCG offers clients a multidisciplinary approach to meet challenges, pursue opportunities, and serve constituents across the public sector. To learn more, visit ***************************** .
We are seeking a dedicated and experienced attorney to join our legal team. The ideal candidate will provide legal support across various areas within the PCG family of companies, promoting compliance and mitigating risks while contributing to our business objectives.
**Intellectual Property, Acquisitions, and Contracts**
We are seeking a dedicated and experienced attorney to join our legal team.
The ideal candidate will provide legal support for the PCG family of companies in a variety of areas, with special attention to intellectual property matters, acquisitions, and contracts, promoting compliance and mitigating risks while contributing to business objectives.
**_Job Requirements:_**
+ Provide guidance and support to management and project teams in areas including intellectual property (trademark and copyright), business acquisitions, contracts, privacy, compliance, litigation, and government procurements.
+ File and maintain trademark registrations.
+ Draft corporate governance documents.
+ Draft and review contracts with clients, teaming partners, subcontractors, vendors, and others.
+ Review RFPs and other solicitations for risks and mitigation strategies.
+ Advise on company policies and compliance matters.
+ Manage outside counsel in administrative matters and in litigation, and for specialized research projects.
+ Perform other duties and functions as assigned
**_Job Qualifications:_**
+ Specialized knowledge and experience that reflects the diverse responsibilities of the position, including intellectual property, corporate law, corporate governance, acquisitions, and contracts.
+ In-house experience preferred.
+ Excellent legal and legal writing skills.
+ Excellent communication, multitasking, and interpersonal skills.
+ Law degree and bar membership.
+ Minimum 5 years of relevant experience as an attorney.
+ Hybrid position requires weekly attendance in the Boston office.
+ Some travel may occasionally be required for hearings and other proceedings.
\#LI
**As required by applicable law, PCG provides the following reasonable range of compensation for this role: $150,000-$200,000. In addition, PCG provides a range of benefits for this role, including medical and dental care benefits, 401k, PTO, parental leave, bereavement leave.**
**Compensation:**
Compensation for roles at Public Consulting Group varies depending on a wide array of factors including, but not limited to, the specific office location, role, skill set, and level of experience. As required by applicable law, PCG provides the following reasonable range of compensation for this role below. In addition, PCG provides a range of benefits for this role, including medical and dental care benefits, 401k, PTO, parental leave, bereavement leave.
**EEO Statement:**
Public Consulting Group is an Equal Opportunity Employer dedicated to celebrating diversity and intentionally creating a culture of inclusion. We believe that we work best when our employees feel empowered and accepted, and that starts by honoring each of our unique life experiences. At PCG, all aspects of employment regarding recruitment, hiring, training, promotion, compensation, benefits, transfers, layoffs, return from layoff, company-sponsored training, education, and social and recreational programs are based on merit, business needs, job requirements, and individual qualifications. We do not discriminate on the basis of race, color, religion or belief, national, social, or ethnic origin, sex, gender identity and/or expression, age, physical, mental, or sensory disability, sexual orientation, marital, civil union, or domestic partnership status, past or present military service, citizenship status, family medical history or genetic information, family or parental status, or any other status protected under federal, state, or local law. PCG will not tolerate discrimination or harassment based on any of these characteristics. PCG believes in health, equality, and prosperity for everyone so we can succeed in changing the ways the public sector, including health, education, technology and human services industries, work.
Public Consulting Group is an equal opportunity employer. All qualified applicants receive consideration for employment without regard to race, color, religion, gender, national origin, age, sexual orientation, gender identity, protected veteran status, or status as a qualified individual with a disability. VEVRAA Federal Contractor.