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Associate Counsel - Digital Health/ Contracting / Credentialing

Remote, USA Full-time Posted 2025-11-24
About Solera Solera Health is committed to changing lives by guiding people seamlessly to better health solutions, while providing payers and employers the tools to manage providers and outcomes across conditions. Solera's platform provides a marketplace of curated networks of digital and community point solutions focused on intensive, evidence-based lifestyle, behavioral, and social interventions to impact the most prevalent and costly chronic conditions. Solera strategically matches consumers to their best-fit solution and helps keep them engaged for successful health outcomes. About the Role We're seeking an experienced Associate Counsel to support our rapidly scaling digital health and wellness network. Reporting to the General Counsel/CISO, this role provides critical legal leadership across payor relationships, digital health provider contracting, billing operations, and delegated credentialing programs. If you bring deep expertise in healthcare billing regulations, claims processing, payer contracting, credentialing compliance, and digital health partnerships, this position offers a high-impact opportunity to shape the future of Solera’s digital health ecosystem. About the Role As Associate Counsel, you’ll serve as a trusted partner to Solera’s legal, operations, and network teams—driving excellence in payor relationships, optimizing digital health provider partnerships, and supporting compliant billing and credentialing operations. You’ll manage a high volume of commercial agreements, monitor complex regulatory requirements, and translate them into actionable guidance for cross-functional teams. This is both a strategic and hands-on role, ideal for someone who thrives in fast-moving digital health environments and enjoys building scalable legal infrastructure. What You’ll Do Contracting & Transactional Support (60%) • Draft, review, and negotiate commercial agreements including MSAs, SOWs, NDAs, BAAs, payor contracts, provider agreements, billing service agreements, and credentialing contracts. • Structure and negotiate digital health partnership agreements and provider network relationships. • Lead high-volume contract review for provider onboarding and network expansion. • Develop and maintain contract templates for payor, provider, and digital health partnerships. • Manage delegated credentialing agreements and contracting frameworks with health plans. • Support amendments, contract performance monitoring, and value-based care arrangements. • Build strong relationships with payor legal teams, digital health partners, and stakeholders. Billing, Claims & Credentialing Legal Guidance (25%) • Provide legal counsel on billing and claims processing requirements, including 837 filing, CMS regulations, and reimbursement structures. • Review and optimize billing policies, procedures, and operational compliance. • Support billing dispute resolution, claim denials, and payor audit responses. • Advise on provider enrollment, NPI taxonomy, CAQH processes, and billing eligibility. • Support delegated credentialing program oversight and provider verification standards. • Provide legal review for new billing processes and payor requirements. Regulatory Monitoring & Compliance (15%) • Maintain monitoring systems for regulatory changes related to billing, credentialing, digital health, and payor requirements. • Conduct legal research on federal/state billing regulations, provider licensing, and digital health rules. • Prepare legal memoranda and impact analyses for evolving regulatory requirements. • Monitor payor policy changes affecting provider networks, credentialing, and digital health operations. • Support corporate compliance initiatives and risk mitigation strategies. What You Bring • Juris Doctor (JD) from an accredited law school. • Active bar license in good standing. • 3–7 years of relevant healthcare legal experience, ideally in digital health, payor operations, health technology, or billing/credentialing regulatory work. • Strong expertise in healthcare billing, claims processing, and regulatory compliance. • Demonstrated success negotiating payor and digital health provider contracts. • Experience with NPI taxonomy, CAQH, provider enrollment, and credentialing requirements. • Familiarity with delegated credentialing frameworks and verification processes. • Deep understanding of CMS billing regulations and Medicare/Medicaid reimbursement rules. • Proven ability to manage high-volume contract workflows. • Strong research, analytical, and communication skills. • Comfortable working cross-functionally with operations, billing, product, and network teams. Key Competencies • Healthcare billing and claims processing expertise • Payor and provider contract negotiation • Delegated credentialing program knowledge • CMS and digital health regulatory fluency • Provider network contracting • High-volume contract management • Regulatory monitoring and impact analysis • Relationship building & cross-functional collaboration Location & Travel • Remote-first role based in the United States • Occasional travel to corporate sites (approx. 5-10%) Benefits • Remote-first culture • Competitive compensation • Unlimited PTO • Medical, dental & vision insurance • 401(k) with company match • Professional development and certifications • Wellness programs • Company-sponsored training opportunities Disclaimer: The information contained herein is not intended to be an all-inclusive list of the duties and responsibilities of the job, nor are they intended to be an all-inclusive list of the skills and abilities required to do the job. Management may, at its discretion, assign or reassign duties and responsibilities to this job at any time. Solera Health provides equal employment opportunities (EEO) to all employees and applicants for employment without regard to race, color, religion, sex, national origin, age, disability or genetics. In addition to federal law requirements, Solera Health complies with applicable state and local laws governing nondiscrimination in employment in every location in which the company has facilities. This policy applies to all terms and conditions of employment, including recruiting, hiring, placement, promotion, termination, layoff, recall, transfer, leaves of absence, compensation and training. Original job Associate Counsel - Digital Health/ Contracting / Credentialing posted on GrabJobs ©. To flag any issues with this job please use the Report Job button on GrabJobs. Apply tot his job Apply To this Job

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