In-House Q&A: UnitedHealthcare's Elizabeth Kremenak

Elizabeth Kremenak is Senior Associate General Counsel at UnitedHealthcare. She has also taught as an adjunct law professor in the areas of healthcare compliance, governance, and ethics.

Elizabeth has extensive experience in regulatory issues, strategic planning, and managing risk in the context of business growth.

Today, she shares some of the lessons she learned in becoming an in-house attorney and weighs in on emerging roles for lawyers in healthcare.

Thanks for taking the time to chat with me today. Let’s start with a bit about your background. How’d you end up in your current role?

I started off at the Minnesota Attorney General’s Office. At first, I did everything from general civil litigation to charitable organization and trust regulation.

Even then I knew that I eventually wanted to go into a healthcare setting though, so I wound up prosecuting fraud and abuse in the Medicaid Fraud Control Unit of the Attorney General’s Office. I was getting some great experience within the Attorney General’s Office.

Still, I eventually wanted to transition to the private sector, so I began growing my network. I developed a contact I trusted who told me that compliance was a good area to get into in order to move to the private sector.

Following that advice, I did compliance work at the Target Corporation for about four years. Finally, I applied for a role at UnitedHealthcare as an Associate General Counsel where I was promoted to the role I am in today as Senior Associate General Counsel.

It sounds like you were drawn to healthcare law early on. Why was that? Did something in your past push you in that direction?

My dad is still an attorney, and in his career, he had a big focus on healthcare, especially within the insurance industry.

The help he was able to provide to people facing illness, especially cancer and mental health patients, in Minnesota and the things he was able to change showed me that being a lawyer within the healthcare industry is a way to make real change in the community.

It’s also a challenging, innovative, and complex area of the law. You’re not going to get bored.

So what are you actually doing on a day-to-day basis?

I support UnitedHealthcare’s Community and State, also known as Medicaid, business. There are millions of members in 31 states plus Washington D.C.

I lead the West regional legal team, which covers markets stretching from the State of Hawaii all the way to the State of Kansas. Attorneys support each of these markets. That means I meet with several different business partners just about every day.

For example, you might find me meeting with several health partners or a market CEO on any given day. We meet with the whole team about once a month too.

I also support regulatory affairs and advocacy matters, addressing trends across the states, and making sure that there’s alignment in any matters that need to get escalated or discussed.

It’s almost become obligatory now for me to ask whether these meetings are taking place in-person or remotely.

We’ve mostly been doing them remotely. The team is located all over the country. A lot of this is going to be remote regardless of the pandemic.

A certain percentage of United employees were already able to conduct most of their work remotely at the start of the pandemic, and the rest caught up pretty quickly.

For those who hadn’t been using videoconferencing technology all that much before, was it a difficult transition?

I actually only started myself about two weeks before the lockdowns were put in place. It was a steep learning curve being in a new job just as everyone else was dealing with a new business atmosphere too.

Since I started at UnitedHealthcare right as the pandemic was beginning, I’m probably not the best one to ask about what things were like before. My understanding though is that they always leveraged remote learning technology.

Sounds like they were already pretty well set-up to deploy those distance work technologies.

Exactly. It’s something that is very helpful for any business that has a wide geographic footprint, especially videoconferencing. You feel like you’re in the same room.

Something I like to ask lawyers whether they have tips for anyone new who wants to see themselves in a similar place in the future. Any advice for current or potential law students?

It’s important to think about where you want to be in 10 years — important because everybody needs a goal. You need to strategize on how you’re going to get to that goal.

Build experiences and skillsets you need to get where you want to go. Think about who you need to talk to, who’s going to be your mentor. Don’t get too stuck on what you’re doing now. Do the best you can, but recognize that you learn from mistakes and should keep going, too. Think ahead. Have a long-term plan.

Do you see job growth coming in your own area within, say, 10 years?

I can’t speak on behalf of the company in particular, but there are going to be a lot of opportunities in healthcare in general. In general, the industry is changing the way care is both provided and covered.

New collaborative arrangements are being created, strategies to identify and address opportunities for getting care to various populations are being discussed and implemented. Additionally, government policymakers are investing more time and research about the capabilities within the health system to be innovative and collaborative.

This whole landscape of innovation has opened up as a result of the pandemic, like telehealth, for instance — it bridges care gaps in ways that weren’t otherwise previously feasible. There are going to be so many different job roles that we wouldn’t have even considered five years ago.

So, yeah, I would say there is going to be a lot of opportunity in legal and roles within the healthcare system.

Well, that’s great to hear. Thank you very much for taking the time to talk today. I think we really covered some useful information. Any parting thoughts you want to leave the readers with?

As you think about becoming an in-house attorney, the most important thing you can do is learn your business. Really dig in to understand it.

People don’t readily grasp that in law school. Learn your business first and then apply your legal knowledge and experiences.

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Jonathan Wolf is a civil litigator and author of Your Debt-Free JD (affiliate link). He has taught legal writing, written for a wide variety of publications, and made it both his business and his pleasure to be financially and scientifically literate. Any views he expresses are probably pure gold, but are nonetheless solely his own and should not be attributed to any organization with which he is affiliated. He wouldn’t want to share the credit anyway. He can be reached at [email protected].