Chief Legal Officer

Responsibilities

• Serve as a strategic advisor to the CEO, Board of Directors, and Executive Leadership Team on legal, regulatory, governance, and enterprise risk matters.
• Serve as Corporate Secretary, overseeing Board governance, resolutions, committee support, and corporate records.
• Advise leadership regarding strategic initiatives, acquisitions, joint ventures, investments, and other corporate transactions.
• Develop legal strategies that enable business growth while appropriately managing organizational risk.
• Build trusted relationships across the organization as a collaborative business partner and advisor.
• Lead all legal affairs of the organization, including commercial transactions, litigation management, employment matters, intellectual property, corporate governance, and regulatory compliance.
• Draft, negotiate, and oversee complex commercial agreements with a primary focus on healthcare payer contracts, provider agreements, strategic partnerships, technology agreements, vendor contracts, and business associate agreements.
• Provide legal guidance on new products, strategic initiatives, artificial intelligence, data use, and healthcare innovation.
• Manage legal risks associated with corporate operations and recommend practical business solutions.
• Direct all litigation, dispute resolution, and legal investigations while managing outside counsel.
• Serve as the executive legal advisor for all healthcare payer contracting activities.
• Lead legal negotiations involving national and regional health plans, delegated service agreements, value‑based arrangements, and strategic partnerships.
• Partner with Commercial, Operations, Product, and Clinical leadership to structure innovative client agreements while protecting Avalon’s legal and financial interests.
• Advise leadership on reimbursement, delegation, utilization management, privacy, and regulatory implications of contractual arrangements.
• Provide executive oversight of the Corporate Compliance and Privacy programs.
• Ensure organizational compliance with HIPAA, HITECH, CMS, NCQA regulations, state insurance regulations, fraud, waste and abuse requirements, and other applicable healthcare laws.
• Oversee enterprise compliance investigations, corrective action plans, and regulatory reporting.
• Direct privacy governance, breach response, and enterprise data protection strategies.
• Foster a culture of ethics, integrity, and compliance throughout the organization.
• Provide executive oversight of the Internal Audit function and enterprise risk management activities.
• Establish risk‑based audit priorities that support operational excellence and regulatory compliance.
• Monitor organizational risks and ensure appropriate mitigation strategies are implemented.
• Present audit findings, risk assessments, and compliance updates to executive leadership and the Board.
• Lead the organization’s government affairs strategy at both the federal and state levels.
• Develop relationships with legislators, regulators, industry associations, and other key stakeholders.
• Manage lobbying activities and outside government affairs consultants.
• Monitor legislative and regulatory developments affecting Avalon and proactively advise executive leadership.
• Represent Avalon before governmental agencies and industry organizations as appropriate.
• Lead and develop a high‑performing legal, compliance, privacy, audit, and government affairs organization.
• Provide coaching, mentoring, and career development for direct reports and department staff.
• Manage departmental budgets, outside legal counsel, consultants, and vendor relationships.
• Establish departmental goals, performance metrics, and succession plans.
• Drive operational excellence through process improvement and technology enablement.

Requirements

• Juris Doctor (JD) from an accredited law school.
• Active license to practice law in at least one U.S. jurisdiction.
• Minimum of 15 years of progressively responsible legal experience, including significant in‑house healthcare experience.
• Minimum of 8 years of executive leadership experience managing legal and compliance functions.
• Demonstrated experience reporting directly to executive leadership.
• Extensive experience negotiating and drafting complex healthcare contracts, particularly with national and regional health plans.
• Deep knowledge of healthcare regulatory frameworks, including HIPAA, HITECH, CMS regulations, Medicare, Medicaid, fraud and abuse laws, and state insurance regulations.
• Experience leading enterprise compliance and privacy programs.
• Experience supporting mergers, acquisitions, strategic partnerships, and corporate transactions.