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Years of Experience
Date Last Verified
ProfileAssociate General Counsel The candidate's primary responsibilities: Transactional work including review and negotiation of proposed business arrangements and contracts (payer and vendor); Risk management (patient and vendor complaints, medical / nursing board investigations, QIO inquiries; Pre-litigation (respond to subpoenas, records requests, demands and inquiries), preparing and reviewing contracts (vendor, services, join ventures, provider, payer and creation of templates); Compliance investigations, scope of practice analysis, conducting regulatory analysis on proposed arrangements (Federal and state regulatory requirements along with Stark, Anti-Kickback and CMP), acquisitions of physician practices, physician employment agreements, addressing and responding to regulatory inquiries, corporate governance (e.g., ensure compliance with home health/hospice Medicare Conditions of Participation), analysis of downstream risk arrangements, corporate practice of medicine, scope of practice, contractual audits to ensure compliance with Medicare Conditions of Participation; Lead privileged audits of business activities and assist in creating plans to respond to any issues identified; Conduct HIPAA analysis; Respond to RFPs; Assist in the legislative process by proposing new legislation and responding to proposed legislation.
Qualification and Experience
The candidate should have Juris Doctorate degree. Should have 1-5 years of experience practicing health law, including physician practices, with direct experience advising clients on federal fraud and abuse laws including Stark, Anti-Kickback and the False Claims Act. Demonstrated understanding of business problems related to assigned legal projects. Well developed written and verbal communications skills. Excellent presentation skills. Experience with risk bearing entities and Medicare Advantage and/or other managed care programs, provider, network, and licensing issues.
Contest Number: 717013