Medicare Risk Assessment Jobs in California (NOW HIRING)

California Salary Range: $120,970 - $181,455Job SummaryThe Associate Counsel serves as a member of CenCal Health’s In-House Legal Team and provides legal guidance on matters affecting the organization’s operations, contracts, regulatory compliance, and public agency responsibilities. This position supports compliance with applicable state and federal laws, Medi-Cal and Medicare requirements, contractual obligations, and public agency regulations. The Associate Counsel advises management, staff, committees, and the Board of Directors; supports provider and vendor contracting, procurement, appeals, disputes, and litigation matters; and helps assess and mitigate legal risk in alignment with CenCal Health’s mission and operational priorities.Key areas of responsibility include:Regulatory Compliance & Contract ManagementRisk Management & Dispute ResolutionCorporate GovernanceOther Assigned DutiesDuties & Responsibilities1. Regulatory Compliance & Contract ManagementConducts legal research and provides analysis and advice regarding applicable state and federal laws, regulations, contracts, and operational matters.Supports legal staff with Medi-Cal and Medicare benefit denial appeals, administrative hearings, and related statements of position.Assists with legal disputes and regulatory matters, including bankruptcies, IRS inquiries, recoupments and overpayments, government claims, Public Records Act requests, filings, and subpoenas.Advises on provider, vendor, procurement, and contracting matters, including drafting, review, negotiation, legal sufficiency, compliance, and risk mitigation.2. Risk Management & Dispute ResolutionProvides legal guidance, leadership, and risk assessment support to the Legal Division under the general supervision of the Legal Officer.Supports litigation matters by coordinating with outside counsel, conducting research, reviewing internal records, assisting with discovery, drafting or reviewing filings, and participating in hearings, mediations, and settlement activities3. Corporate GovernanceAdvises management, staff, committees, and the Board of Directors on legal and regulatory compliance, including Medi-Cal, Medicare, public agency requirements, the Ralph M. Brown Act, and confidentiality matters.Oversees Legal Division administrative functions, including budgets, department assessments, policies and procedures, outside counsel engagement, invoice approvals, and planning documents.4. Other Assigned DutiesPerforms special projects and other legal functions assigned by the Legal Officer.Knowledge/Skills/AbilitiesExtensive knowledge of Medi-Cal and related legal issues, including administrative hearings, contractual requirements, and operational obligations.Extensive experience with vendor and provider contracting, including legal sufficiency review and risk mitigation.Working knowledge of federal and state laws and regulations governing Medicaid, Medicare, public agencies, and public health programs.Ability to work effectively with outside counsel and monitor performance on general and specialized legal matters.Strong oral and written communication skills, with the ability to convey legal guidance clearly and build trust with internal leaders and external partners.Ability to exercise sound judgment, assume responsibility, and make decisions within the scope of assigned authority.Ability to prioritize multiple assignments, meet deadlines, and complete work accurately within established timeframes.Ability to maintain confidentiality and handle sensitive information with discretion.Demonstrated leadership skills that support a culture of excellence, accountability, collaboration, and continuous improvement.Ability to help staff understand legal reasoning and apply guidance to the development of written agreements and related work products.Understanding of organizational risk and the ability to evaluate legal considerations in relation to operational and community impact.Education & ExperienceJuris Doctorate from an ABA-accredited law school and current membership in good standing with the California Bar.Minimum of five (5) years of progressively responsible legal experience in comparable roles.Management or supervisory experience preferred.Contracting experience involving legal sufficiency review and risk mitigation required.Experience in Medi-Cal/Medicaid managed care and/or Medicare strongly preferred. #J-18808-Ljbffr