Health Benefit Plan Consulting Attorney

Job overview

The Health Benefit Plan Consulting Attorney role is hybrid in Canton, MA, with a flexible teleworking schedule if appropriate. Compensation is $90,000–$110,000 per year. The Phia Group provides health-plan clients nationwide with cost-containment consulting and supports its mission of high-quality, affordable healthcare. The attorney advises on legal, regulatory, and compliance issues affecting health plans and their administrators. The role reviews claims and appeals, researches applicable law, drafts plan documents and memoranda, and helps clients and internal teams resolve complex healthcare matters.

What you'll do

• Review member and provider appeals, grievances, and complex claims issues
• evaluate benefit exclusions, plan terms, and medical-necessity disputes
• coordinate independent clinical reviews
• review communications for legal sufficiency and compliance
• support audits and corrective action plans
• conduct legal research and draft memoranda
• review healthcare contracts
• respond to client inquiries
• draft ERISA- and ACA-compliant plan documents, including MHPAEA reports
• analyze health plans and summarize findings.

What we're looking for

Skills & competencies

health benefit plan consulting attorney

hybrid

canton ma

the phia group

full-time

health plan law

erisa

aca

mhpaea

hipaa

claims and appeals

$90k–$110k/year

Work arrangement

• Weekend coverage required

Why this role

The posting notes a hybrid schedule and flexible teleworking when appropriate; healthcare-industry experience is preferred.

About the employer

The Phia Group is hiring for this role. Industry: All Other Professional, Scientific, and Technical Services. Sector: 54.