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Inovalon

Cloud-based healthcare data analytics and BI

Associate General Counsel - Regulatory and Commercial

Legal Counsel & Legal SupportUpdated on Nov 11
Full-time$170k - $245k /yrHybrid

About the Job

Requirements

  • A minimum of 12 years of legal experience, including at least five years of specialized healthcare experience in a law firm, corporate legal department, federal healthcare agency, or similar environment is required.
  • A J.D. degree from an accredited law school and a license to practice law in any U.S. state or Washington, D.C., or an equivalent combination of education and experience, is required.
  • Significant experience with healthcare regulatory and transactional matters is required.
  • Working knowledge of HIPAA, business associate agreements, and health-data de-identification is required.
  • Familiarity with payer operations and CMS programs, including risk adjustment and quality measurement such as HEDIS and Star Ratings, as well as provider-facing data and interoperability arrangements, is required.
  • Substantial experience drafting, reviewing, and negotiating complex commercial agreements and advising business partners on them is required.
  • The candidate must be able to provide strategic regulatory advice and communicate complex legal and regulatory concepts clearly and concisely to senior management, Sales, Product, and other business leaders.
  • The candidate must be authorized to work in the United States.
  • The candidate must maintain compliance with company policies, procedures, and mission commitments, including confidentiality and HIPAA requirements concerning data handled or services rendered.

Responsibilities

  • Serve as a strategic legal advisor to business leaders and senior executives on healthcare regulatory, privacy, commercial, and corporate matters affecting the company’s products, services, and go-to-market strategies.
  • Guide the legal and regulatory structure of commercial transactions, including matters involving the Anti-Kickback Statute, False Claims Act, healthcare fraud and abuse laws, and related compliance considerations.
  • Lead the drafting, review, negotiation, and resolution of complex commercial agreements, including customer, vendor, data, and other business-critical contracts, balancing legal risk and business objectives.
  • Counsel teams supporting Medicare Advantage, ACA, and Medicaid risk adjustment programs on RADV audits, chart review, supplemental data submissions, provider engagement, and fraud, waste, and abuse risk.
  • Advise on HIPAA, HITECH, applicable state privacy laws, and the use, disclosure, de-identification, tokenization, linking, and commercialization of health data, including business associate agreements, subcontractor business associate agreements, and data use agreements.
  • Partner with product, sales, and business teams on healthcare analytics, artificial intelligence, software as a service, data strategy, interoperability, information blocking, and 21st Century Cures Act considerations to enable compliant product and commercial execution.
  • Support specialty pharmacy-related matters, including hub services, patient support and adherence programs, manufacturer, pharmacy, and payer arrangements, copay and patient assistance considerations, and applicable pharmacy and pharmacy benefit manager regulation.
  • Provide legal support on non-commercial matters as needed, including pre-litigation issues, disputes, customer correspondence, regulatory inquiries, subpoenas, and broader legal initiatives that advance enterprise priorities.
  • Contribute to process improvements, playbooks, templates, and contract lifecycle tooling to improve the Legal function’s consistency, scalability, and execution.
  • Fulfill additional responsibilities and duties reasonably assigned to support the employer’s operational and financial success.

Desired Qualifications

  • Exposure to specialty pharmacy, hub services, or pharmacy and pharmacy benefit manager regulation is desirable.

About the Company

Inovalon

Cloud-based healthcare data analytics and BI

Inovalon provides cloud-based software that helps healthcare organizations use data to improve patient care and operations. Its platform offers real-time data access and national-scale connectivity, with over 100 analytics and business-intelligence tools delivered via a subscription, plus consulting services to maximize value. Unlike point-solution competitors, it offers an end-to-end, cloud-based platform that connects providers, payers, pharma, and life sciences for broad, data-driven workflows. The goal is to improve clinical outcomes, boost operational efficiency, and enhance financial performance by turning healthcare data into actionable insights.

Company size
1,001-5,000
Company stage
IPO
Headquarters
Bowie, MD
Founded
1997

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