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Organization TypePublic Interest
Years of Experience
Date Last Verified
Counsel, Reimbursement The candidate will have the authority to recommend retaining outside counsel where internal resources / knowledge / capacity limits the ability to effectively manage an issue internally. If outside counsel is retained at the recommendation of Counsel, they will have the responsibility for managing outside counsel's work and associated expenses. Assists the Assistant General Counsel, General Counsel, other more senior attorneys, and members of Sutter Health and Affiliate management by providing legal advice and counsel on relationships between providers and payers of health care services. The primary area of focus will be state and federal healthcare programs, including Medicare, Medicare Advantage, and Medicaid. Will perform a wide variety of legal services, including providing advice and counsel, developing policies and procedures, identifying new or emerging areas of risk, conducting or overseeing legal research, preparing and presenting education and training, and providing support on specific legal projects related to health care operations. The Counsel is a member of the Legal Services Division in the Office of the General Counsel. The incumbent will serve as a member of a team providing legal services to a large integrated health care delivery system. The Counsel often works independently with general supervision and direction of more senior lawyers within the Office of the General Counsel, and will work in coordination with other members of the OGC team.
Qualification and Experience
\The candidate must possess a Juris Doctor degree from an accredited law school. Must be a member in good standing with a state Bar. Must have demonstrated 4 years of significant experience practicing law, including primary and independent responsibility for legal advice on significant regulatory and compliance matters. Must have an extensive knowledge of Medicare and Medicaid reimbursement, as well as familiarity with fraud and abuse laws, such as the Stark law, Anti-kickback Statute, Civil Monetary Penalties Statute. Should have experience advising on Medicare/Medicaid enrollment and certification, and the laws affecting relationships between providers and patients. Extensive experience providing legal advice to health care clients required, including hospitals and medical foundations/physician organizations. Experience working with or for an integrated healthcare delivery system strongly preferred. Must demonstrate excellent written and verbal communication skills as well as the ability to translate legal complexities into terms readily understood by management and line personnel. Must have demonstrated initiative and an ability to work in a fast paced complex matrixed managed organization. Must be able to demonstrate strong client management and project management skills as well as the ability to work successfully both independently and within a team.
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