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Health Care Attorney / Litigation Attorney in Torrance, CA

DaVita HealthCare Partners Inc Oct 20,2014 Sep 06,2014 Location Torrance CA
This job is expired...

In-House

Attorney

Health Care

Litigation

Litigation - Whistleblower - CFTC

10-15 yrs required

Profile

Assistant General Counsel – Plan and Provider Contracting Candidate will serve as the lead lawyer for and a key member of HealthCare Partner’s national Contracting team. Will provide advice, guidance and strategic counsel to senior management; draft, review, negotiate and implement contracts with plans, providers, and hospitals across the Company, as well as oversee the legal aspects of the relationships and as applicable, disputes. Coordinating, managing and providing strategic advice on the full spectrum of plan, hospital, and provider contracting issues across the enterprise, with special emphasis on Medicare Advantage and risk contracting. Serving as the senior attorney for the contracting and plan relations teams. Working closely and collaboratively with the Contracting senior leadership, operations teams and JLD leadership team, to set strategy, regularly review and update best demonstrated practices (“BDPs”) and execute process improvements to better align and anticipate changing healthcare reform laws and regulations, including future reimbursement programs. Drafting, reviewing, analyzing, negotiating and implementing all plan, hospital, and provider templates, agreements and memoranda. Functioning as the senior subject matter expert in plan, provider, and hospital disputes from informal dispute resolution through arbitration and litigation. Preparing, overseeing and managing the budget for Contracting’s outside professional support (to be rolled up into the broader “corporate support” budget) including negotiation of preferred provider and alternative fee arrangements with outside counsel. Serving as the enterprise subject matter expert, including training the organization on contracting BDPs, new and/or revisions to template agreements, new and/or revisions to reimbursement or other regulatory changes that can or will impact contracts with plans, providers and hospitals. Working as part of a cross-functional team to ensure compliance with HCP’s Restricted Knox Keene license in California. Performing special assignments or projects as assigned.

Qualification and Experience

Candidate should have a Law degree from a top tier law school. 10-15 years of professional legal experience (ideally 5+ years of which should be at a nationally-recognized law firm representing health plans; and 3+ years’ in-house with a health plan offering commercial and Medicare Advantage plans) is required. Knowledge of relevant laws and regulations impacting plan, provider and hospital contracting (including the Accountable Care Act, Medicare Advantage regulations and Medicare Marketing Guidelines), as well as experience handling informal dispute resolution through arbitration and litigation is key is needed. Must possess an ability and experience in working with federal, state and local regulatory agencies, including state departments of insurance / managed care.

Company info