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Years of Experience
Date Last Verified
ProfileSenior Health Plan Corporate Counsel The candidate will report to the VP Assistant General Counsel. Will manage complex legal projects and provide appropriate advice that is informed by realistic risk assessment. Provide legal support for various departments and cross-disciplinary teams, such as provider network relations, claims processing, customer service, marketing, product development, corporate shared services, and regulatory affairs. Negotiate, draft, and interpret health care network provider agreements such as physician, medical group, hospital, and pharmacy related agreements. Provide legal guidance and support to in connection with responses to requests for proposals, and other expansion activities. In collaboration with compliance professionals, provide counsel regarding data privacy issues including HIPAA. In collaboration with compliance professionals and other in-house counsel, monitor and interpret state and federal regulatory requirements and interacting with regulators to ensure the company's regulatory compliance. Should be a member in good standing of a State Bar. Must have strong academic credentials and 5-12 years of legal experience in law firm or in-house settings, ideally with demonstrated expertise in health insurance and managed care. Should preferably have substantial experience in the Medicare and Medicaid programs, and with health care provider contracting. Periodic travel may be required.
Ref. #: 1702275