Medicare & Healthcare Regulatory Compliance/Contracting * Provide legal advice regarding Medicare ... Support corporate growth initiatives, product development, and strategic transactions as needed.
Medicare & Healthcare Regulatory Compliance/Contracting * Provide legal advice regarding Medicare ... Support corporate growth initiatives, product development, and strategic transactions as needed.
Provide market feedback to inform future product development and innovation. * Support general ... Working knowledge of pharmacy benefit management, Medicare Part D, and commercial pharmacy benefits
Provide market feedback to inform future product development and innovation. * Support general ... Working knowledge of pharmacy benefit management, Medicare Part D, and commercial pharmacy benefits
Reimbursement Consult
Lafayette, CO · On-site
Support HEPR activities on product development core teams and product launch teams, including ... S. medical device reimbursement, including coding, coverage, and payment concepts across Medicare ...
Reimbursement Consult
Lafayette, CO · On-site
Support HEPR activities on product development core teams and product launch teams, including ... S. medical device reimbursement, including coding, coverage, and payment concepts across Medicare ...
Reimbursement Consult
Lafayette, CO · On-site +1
Support HEPR activities on product development core teams and product launch teams, including ... S. medical device reimbursement, including coding, coverage, and payment concepts across Medicare ...
Reimbursement Consult
Lafayette, CO · On-site +1
Support HEPR activities on product development core teams and product launch teams, including ... S. medical device reimbursement, including coding, coverage, and payment concepts across Medicare ...
Support HEPR activities on product development core teams and product launch teams, including ... S. medical device reimbursement, including coding, coverage, and payment concepts across Medicare ...
Support HEPR activities on product development core teams and product launch teams, including ... S. medical device reimbursement, including coding, coverage, and payment concepts across Medicare ...
Support HEPR activities on product development core teams and product launch teams, including ... S. medical device reimbursement, including coding, coverage, and payment concepts across Medicare ...
Support HEPR activities on product development core teams and product launch teams, including ... S. medical device reimbursement, including coding, coverage, and payment concepts across Medicare ...
Director, Product Delivery (Claims)
Englewood, CO · On-site
$117K - $206K/yr
We provide extensive opportunities for personal and professional development, building both ... Experience working with Medicare and/or Commercial claims data required. * Experience leading ...
Director, Product Delivery (Claims)
Englewood, CO · On-site
$117K - $206K/yr
We provide extensive opportunities for personal and professional development, building both ... Experience working with Medicare and/or Commercial claims data required. * Experience leading ...
Community Partnership Representative
Denver, CO · On-site
$80/hr
... development, and outreach initiatives focused on Medicare-eligible seniors. This role serves as a ... EXPERIENCE: * Knowledge of Medicare products, healthcare services, and senior populations.
Community Partnership Representative
Denver, CO · On-site
$80/hr
... development, and outreach initiatives focused on Medicare-eligible seniors. This role serves as a ... EXPERIENCE: * Knowledge of Medicare products, healthcare services, and senior populations.
RVP, Business Development
Denver, CO · On-site +1
Proficiency in Microsoft suite of products including Outlook, Word, and Excel. Possession of a ... Vaccine Requirement As an employer accepting Medicare and Medicaid funds, employees must comply ...
RVP, Business Development
Denver, CO · On-site +1
Proficiency in Microsoft suite of products including Outlook, Word, and Excel. Possession of a ... Vaccine Requirement As an employer accepting Medicare and Medicaid funds, employees must comply ...
... development, and outreach initiatives focused on Medicare-eligible seniors. This role serves as a ... EXPERIENCE: * Knowledge of Medicare products, healthcare services, and senior populations.
... development, and outreach initiatives focused on Medicare-eligible seniors. This role serves as a ... EXPERIENCE: * Knowledge of Medicare products, healthcare services, and senior populations.
Director, Compliance Part D / Pharmacy Oversight
Denver, CO · Remote
$136K - $218K/yr
... and Medicare Part D. This role provides strategic direction, oversight, and subject matter ... Support product development, formulary changes, and benefit design with regulatory guidance.
Quick apply
Director, Compliance Part D / Pharmacy Oversight
Denver, CO · Remote
$136K - $218K/yr
... and Medicare Part D. This role provides strategic direction, oversight, and subject matter ... Support product development, formulary changes, and benefit design with regulatory guidance.
... and Medicare Part D. This role provides strategic direction, oversight, and subject matter ... Support product development, formulary changes, and benefit design with regulatory guidance.
... and Medicare Part D. This role provides strategic direction, oversight, and subject matter ... Support product development, formulary changes, and benefit design with regulatory guidance.
Director, Compliance Part D / Pharmacy Oversight
Denver, CO · On-site +1
$136K - $177K/yr
... and Medicare Part D. This role provides strategic direction, oversight, and subject matter ... Support product development, formulary changes, and benefit design with regulatory guidance.
Director, Compliance Part D / Pharmacy Oversight
Denver, CO · On-site +1
$136K - $177K/yr
... and Medicare Part D. This role provides strategic direction, oversight, and subject matter ... Support product development, formulary changes, and benefit design with regulatory guidance.
Director, Compliance Part D / Pharmacy Oversight
Denver, CO · Remote
$136K - $218K/yr
... and Medicare Part D. This role provides strategic direction, oversight, and subject matter ... Support product development, formulary changes, and benefit design with regulatory guidance.
Quick apply
Director, Compliance Part D / Pharmacy Oversight
Denver, CO · Remote
$136K - $218K/yr
... and Medicare Part D. This role provides strategic direction, oversight, and subject matter ... Support product development, formulary changes, and benefit design with regulatory guidance.
RVP, Business Development (West)
Denver, CO · On-site
$180K - $200K/yr
Proficiency in Microsoft suite of products including Outlook, Word, and Excel. Possession of a ... Vaccine Requirement As an employer accepting Medicare and Medicaid funds, employees must comply ...
RVP, Business Development (West)
Denver, CO · On-site
$180K - $200K/yr
Proficiency in Microsoft suite of products including Outlook, Word, and Excel. Possession of a ... Vaccine Requirement As an employer accepting Medicare and Medicaid funds, employees must comply ...
RVP, Business Development (West)
Denver, CO · On-site
$180K - $200K/yr
Proficiency in Microsoft suite of products including Outlook, Word, and Excel. Possession of a ... Vaccine Requirement As an employer accepting Medicare and Medicaid funds, employees must comply ...
RVP, Business Development (West)
Denver, CO · On-site
$180K - $200K/yr
Proficiency in Microsoft suite of products including Outlook, Word, and Excel. Possession of a ... Vaccine Requirement As an employer accepting Medicare and Medicaid funds, employees must comply ...
RVP, Business Development (West)
$180K - $200K/yr
Proficiency in Microsoft suite of products including Outlook, Word, and Excel. Possession of a ... Vaccine Requirement As an employer accepting Medicare and Medicaid funds, employees must comply ...
RVP, Business Development (West)
$180K - $200K/yr
Proficiency in Microsoft suite of products including Outlook, Word, and Excel. Possession of a ... Vaccine Requirement As an employer accepting Medicare and Medicaid funds, employees must comply ...
As a Senior Product Manager, you will lead the strategy, development, and execution of healthcare ... Medicare Advantage, claims, encounters, authorization, or healthcare data experience preferred.
As a Senior Product Manager, you will lead the strategy, development, and execution of healthcare ... Medicare Advantage, claims, encounters, authorization, or healthcare data experience preferred.
Senior Product Manager, Healthcare Automation- Eligibility & Benefits
Denver, CO · On-site
$130K - $171K/yr
As a Senior Product Manager, you will lead the strategy, development, and execution of healthcare ... Medicare Advantage, claims, encounters, authorization, or healthcare data experience preferred.
Senior Product Manager, Healthcare Automation- Eligibility & Benefits
Denver, CO · On-site
$130K - $171K/yr
As a Senior Product Manager, you will lead the strategy, development, and execution of healthcare ... Medicare Advantage, claims, encounters, authorization, or healthcare data experience preferred.
Our product portfolio includes Medicare solutions, life insurance, home healthcare, long-term care ... Weekly training and ongoing professional development Qualifications * Insurance license not ...
Quick apply
Our product portfolio includes Medicare solutions, life insurance, home healthcare, long-term care ... Weekly training and ongoing professional development Qualifications * Insurance license not ...
Medicare Product Development information
What is Medicare Product Development?
Medicare Product Development involves creating, enhancing, and managing health insurance plans specifically designed for Medicare beneficiaries. Professionals in this field analyze market trends, regulatory requirements, and customer needs to design products like Medicare Advantage and Medicare Supplement plans. They collaborate with cross-functional teams such as compliance, marketing, and actuarial departments to ensure products are competitive, compliant, and meet the evolving needs of seniors. Their work helps insurance companies offer attractive and effective health coverage options for people eligible for Medicare.
What are the key skills and qualifications needed to thrive in Medicare Product Development, and why are they important?
To thrive in Medicare Product Development, you need expertise in healthcare regulations, product management, and data analysis, often supported by a degree in healthcare administration, business, or a related field. Familiarity with CMS guidelines, market research tools, and product lifecycle management systems is typically required. Strong project management, communication, and problem-solving skills help professionals collaborate across teams and address complex regulatory challenges. These skills ensure compliant, competitive, and innovative Medicare products that meet both business objectives and beneficiary needs.
What are some common challenges faced by professionals in Medicare Product Development, and how can they be addressed?
One of the most common challenges in Medicare Product Development is keeping up with frequent regulatory changes and ensuring products remain compliant with CMS guidelines. Additionally, balancing market competitiveness with cost-effectiveness can be complex, as it requires ongoing analysis of competitor offerings and member needs. Success in this role often involves close collaboration with actuarial, compliance, and marketing teams to swiftly adapt to changes and develop innovative products. Staying informed through continuous learning and cross-functional teamwork is key to overcoming these challenges.
What is the difference between Medicare Product Development vs Medicare Underwriting?
| Aspect | Medicare Product Development | Medicare Underwriting |
|---|---|---|
| Primary Focus | Designing and creating new Medicare plans and products | Assessing risk and determining eligibility for Medicare plans |
| Required Skills | Market research, product design, regulatory compliance | Risk analysis, data evaluation, policy assessment |
| Work Environment | Collaborative teams with marketing, compliance, and actuarial departments | Analytical setting, often within insurance or health plans |
| Certifications | Health insurance licenses, actuarial credentials (optional) | Health insurance licenses, actuarial credentials (optional) |
Medicare Product Development focuses on creating new Medicare plans, while Medicare Underwriting evaluates risks and eligibility. Both roles require knowledge of health insurance regulations and may involve similar certifications, but their core responsibilities differ significantly in scope and daily tasks.
What are popular job titles related to Medicare Product Development jobs in Colorado?
For Medicare Product Development jobs in Colorado, the most frequently searched job titles are:
What job categories do people searching Medicare Product Development jobs in Colorado look for?
The top searched job categories for Medicare Product Development jobs in Colorado are:
What cities in Colorado are hiring for Medicare Product Development jobs?
Cities in Colorado with the most Medicare Product Development job openings:
Director/Senior Legal Counsel - Medicare, Healthcare Regulatory & Contracting
Denver, CO • On-site
Other
Medical
This job post has expired today. Applications are no longer accepted.
Job description
About Judi Health
Judi Health is a health technology company providing benefit administration solutions to employers, unions, health plans, and government entities. Judi Health replaces fragmented, outdated systems with the industry's first Unified Claims Processing architecture, seamlessly consolidating pharmacy and medical benefit administration on a single, secure platform. By delivering true price transparency, eliminating unnecessary middleman fees, and leveraging advanced AI-powered care delivery, Judi Health helps clients achieve unprecedented operational efficiency and service levels.
At Judi Health, we're deploying the infrastructure our country needs to deliver the healthcare we all deserve. We are the intelligence platform powering benefits plans for millions of Americans and proudly leading the next generation of care. To learn more, visit www.judi.health.
Location: Hybrid (at least 3 days per week in our NYC, Denver, or Charlotte offices)
Position Summary
We are seeking an experienced and business-oriented healthcare attorney to join our Legal team. This role will serve as a strategic legal advisor to senior leadership and business partners, providing legal support across Medicare Part D, healthcare regulatory compliance, contracting, and operational initiatives.
The successful candidate will have deep experience with Medicare, health insurance and healthcare laws, substantial healthcare contracting expertise, and the ability to provide practical legal advice that balances regulatory requirements with business objectives. This attorney will play a key role in supporting a rapidly growing healthcare organization operating in a highly regulated environment.
Position Responsibilities:
Medicare & Healthcare Regulatory Compliance/Contracting
- Provide legal advice regarding Medicare Part D, health insurance and other federal healthcare program requirements.
- Counsel business teams on CMS regulations, guidance, audits, reporting obligations, and regulatory enforcement matters.
- Monitor and interpret changes in healthcare laws and regulations and advise leadership regarding operational impacts.
- Support regulatory change management initiatives and implementation of new legal requirements.
- Advise on regulatory risks associated with business operations, products, and strategic initiatives.
- Assist with government audits, investigations, corrective action plans, and responses to regulatory inquiries.
- Draft, review, negotiate, and advise on a broad range of healthcare and commercial agreements, including:
- Rebate and delegation agreements
- Client agreements
- Network and managed care contracts
- Develop contracting standards, templates, negotiation playbooks, and risk management processes.
- Partner with procurement, operations, compliance, and business teams to facilitate efficient contract review and execution.
- Support vendor selection, due diligence, onboarding, and ongoing oversight activities.
- Provide legal guidance on:
- False Claims Act
- Anti-Kickback Statute
- Stark Law
- Medicare and Medicaid requirements
- State insurance and healthcare regulations
- Support compliance investigations, policy development, training initiatives, and operational audits.
- Provide practical, solution-oriented legal guidance aligned with business objectives.
- Identify legal risks and develop creative, operationally feasible solutions.
- Support corporate growth initiatives, product development, and strategic transactions as needed.
Required Qualifications
- Juris Doctor (J.D.) from an accredited law school.
- Active license and good standing in at least one U.S. state.
- 8+ years of legal experience in a law firm, healthcare organization, health plan, PBM, managed care organization, or combination thereof.
- Significant experience with Medicare Part D regulatory requirements.
- Extensive healthcare contracting experience, including complex commercial and vendor agreements.
- Strong knowledge of federal and state healthcare laws and regulations.
- Experience advising cross-functional business teams in a fast-paced environment.
- Excellent drafting, negotiation, analytical, and communication skills.
- Demonstrated ability to manage multiple priorities independently.
Preferred Qualifications:
- Experience supporting Medicare Advantage plans, PBMs, health plans, TPAs, or managed care organizations.
- Experience with CMS audits, corrective action plans, and regulatory examinations.
- Knowledge of delegated entity and FDR oversight requirements.
- Experience with provider contracting and network management.
- Experience with healthcare technology, data privacy, and digital health products.
- Familiarity with Medicaid and commercial health plan regulations.
- Experience supporting mergers, acquisitions, and strategic healthcare transactions.
Critical Competencies:
- Medicare and CMS regulatory expertise
- Healthcare and vendor contracting
- Healthcare compliance and risk management
- Business-oriented legal judgment
- Practical problem-solving
- Project management and organizational skills
- Collaboration across legal, compliance, operations, and business teams
Why This Role Matters
This attorney will serve as a key member of the Legal organization, helping the company scale responsibly while navigating complex Medicare, healthcare regulatory, and contracting obligations. The role offers the opportunity to shape legal strategy, influence business decisions, and build processes that support continued growth and operational excellence.
This range represents the low and high end of the anticipated base salary range. The actual base salary will depend on several factors such as: experience, knowledge, skills, and location of the job.
Remote, US Salary Range
$130,800—$206,500 USD
New York, NY Salary Range
$165,200—$206,500 USD
Denver, CO Salary Range
$151,200—$189,000 USD
Charlotte, NC Salary Range
$137,600—$172,000 USD
All employees are responsible for adherence to the Judi Health Code of Conduct including the reporting of non-compliance. This position description is designed to be flexible, allowing management the opportunity to assign or reassign duties and responsibilities as needed to best meet organizational goals.
We 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 athttps://www.judi.health/legal/privacy-policy.
About Capital Rx
Sourced by ZipRecruiter
Industry
Health care and social assistance
Company size
201 - 500 Employees
Headquarters location
New York, NY, US
Year founded
2017