Legal Review Specialist – Part-time

About This Opportunity

Our talent team is representing a confidential healthcare consulting organization in their search for a Legal Review Specialist on a part-time, remote basis. This position supports federally funded healthcare programs and Medicare appeals operations, focusing on regulatory and legal analysis of appeal determinations and compliance matters.

Please note: This position is contingent upon contract award. Employment begins once the contract is officially activated.

Responsibilities

• Review appeal determinations, case files, and supporting materials for legal and regulatory sufficiency
• Analyze complex Medicare policy, statutory, and regulatory issues related to appeals and coverage determinations
• Advise internal stakeholders on interpretation and application of Medicare statutes, federal regulations, and agency guidance
• Support responses to government inquiries involving regulatory, legal, or policy-related matters
• Assist in preparation of materials for administrative hearings, adjudicatory reviews, and higher-level appeal proceedings
• Conduct legal and regulatory research to support appeal determinations and program operations
• Evaluate case documentation to ensure consistency with applicable legal and regulatory requirements
• Identify regulatory risks, compliance concerns, and policy implications
• Draft and review legal memoranda, policy analyses, issue papers, and written recommendations
• Collaborate with clinical reviewers, appeals analysts, and operational staff on complex regulatory issues
• Support quality assurance, audit readiness, and compliance review activities
• Monitor changes in Medicare regulations and agency guidance; communicate impacts to stakeholders
• Assist in development and maintenance of policies, procedures, and operational guidance

What We're Looking For

Required:

• Juris Doctor (JD) from an accredited law school preferred; Bachelor's degree required with equivalent legal, regulatory, or healthcare policy experience
• 7+ years of experience supporting Medicare, healthcare regulatory compliance, appeals, program integrity, policy analysis, or federal healthcare programs
• Experience with Medicare statutes, CFR interpretation, or CMS adjudicatory processes
• Strong analytical and legal writing skills
• Ability to interpret complex regulatory and policy materials

Preferred:

• Experience supporting CMS, OGC, or federal healthcare programs

How We Work With You

When you apply through Get A Job.ai, one of our recruiters will screen your qualifications and experience. If there's a strong match, we'll prepare and submit your profile to our client for consideration. Please do not contact the client directly—all communication and coordination will flow through our team to ensure a smooth process.

Pay

Pay details for this role will be discussed during the screening process and are based on experience level.

Equal Employment Opportunity: Get A Job.ai is committed to inclusive hiring practices. We evaluate all candidates based on qualifications and merit.