Assistant Counsel

Position Overview

The Assistant Counsel is a hands-on, individual-contributor attorney serving as a key legal partner to Harbor Health's health plan and clinical operations. Reporting to the Chief Legal Officer, this role is the primary drafting, reviewing, and negotiating resource for the high volume of commercial agreements generated by a fast-growing pay-vider operating simultaneously as an insurer, a multi-specialty medical group, and a value-based care organization — spanning provider, payer, and vendor contracting;

delegated entity oversight; network development; claims, appeals, and grievances; and regulatory compliance.

Harbor Health

Remote Position - United States

The Assistant Counsel is a hands-on, individual-contributor attorney serving as a key legal partner to Harbor Health's health plan and clinical operations. Reporting to the Chief Legal Officer, this role is the primary drafting, reviewing, and negotiating resource for the high volume of commercial agreements generated by a fast-growing pay-vider operating simultaneously as an insurer, a multi-specialty medical group, and a value-based care organization — spanning provider, payer, and vendor contracting;

delegated entity oversight; network development; claims, appeals, and grievances; and regulatory compliance.

The ideal candidate pairs strong health care regulatory knowledge and sophisticated commercial contracting skill with sharp business acumen, thrives owning a heavy and varied docket in a fast-moving legal function, and builds trusted, collaborative relationships across network development, provider relations, product, actuarial, compliance, clinical operations, and finance.

• Provider network agreements:
  Agreements with primary care, specialty, ancillary, facility, and hospital providers, including fee schedules, value-based/risk-sharing exhibits, credentialing terms, and amendment/termination provisions.
• Payer & CMS contracts:
  Value-based, shared-savings, and full-risk payer arrangements (attribution, quality metrics, reconciliation), plus CMS program agreements (e.g., ACO LEAD, MSSP) covering data-sharing and beneficiary alignment.
• Delegated entities:
  Delegation agreements with TPAs, PBMs, behavioral health and utilization management vendors, plus ongoing oversight, compliance monitoring, remediation, and regulatory reporting.
• Employer & Marketplace:
  Employer group plan, ASA, broker, and stop-loss agreements; ACA Marketplace issuer, QHP certification, and enrollment-platform agreements as Harbor's employer and Marketplace books scale.
• Claims & payment integrity:
  Claims adjudication, coordination of benefits, appeals and grievances, and payment integrity vendor agreements.

• Physician & clinician agreements:
  Physician and advanced practice provider employment, professional services, and medical director agreements, including restrictive covenant/compensation provisions (per Texas law) and locum tenens arrangements.
• Specialty & facility affiliations:
  Agreements with specialty partners (cardiology, dermatology, rheumatology, endocrinology, behavioral health, infusion) and hospitals/ancillary providers for referral, coverage, and co-management arrangements.
• Facilities & vendors:
  Lease, amendment, and build-out agreements for clinics, express care sites, labs, and mobile health units; laboratory, imaging, DME, staffing, and other clinical vendor agreements.
• Technology & privacy: EHR, care-coordination, and analytics/SaaS agreements, along with related BAAs and data-sharing agreements under HIPAA and Texas privacy law.

• Advise & support with Compliance to ensure adherence to Texas and federal health care laws applicable to insurers, medical groups, and delegated entities; support TDI, CMS, and other regulatory exams, audits, inquiries, and complaint responses.
• Support legally compliant implementation of clinical programs, quality initiatives, and utilization management controls.
• Monitor and communicate TDI, CMS, and other rule making…