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Years of Experience
Date Last Verified
ProfileContracts Counsel The candidate reviews, analyzes, and redlines third-party regional and national managed care contract documents from initial submission through execution and implementation, including contract comparisons and general compensation analyses ensuring contract and other legal documents reflect managed care strategic goals. Work closely with other departments (Medical Analytics/Reimbursement Systems/Revenue Management and operations) to ensure contractual reimbursement and operational terms are consistent with company’s policies and procedures. Review agreement requests from managed care staff and management clients and determine which agreements are suitable to address clients’ business goals, including Non-Disclosure/Confidentiality Agreements, Business Associate Agreements, Letters of Agreements, supplier agreements, and settlement agreements. Assists field managed care sales staff by interpreting existing contract language. Performs research of managed care legal issues, including state and federal regulations related to Medicare, Medicaid, HMOs, PPOs, and maintains working knowledge of basic healthcare regulatory requirements. Researches State and federal laws and regulations applicable to contract interpretation issues and company processes. Oversees review of, as requested, contract documents or work product produced by Contracts Analysts/Contract Specialists. Drafts correspondence and provides legal advice relative to contract disputes. Oversees special projects as requested by company internal clients.
Qualification and Experience
The candidate must have Four year college degree or equivalent experience. Should have Law degree from an accredited law school. 3+ years of related experience is required. State bar membership is must. Experience redlining provider contracts from the Payor or the Provider side is preferred. Skill in drafting and revising contract language is required. Excellent communication skills, both written (e-mails/letters/memos) and verbal (telephonic and in-person), are a must.
Requisition ID: 2018-3185
26220 Enterprise Court
Lake Forest, CA 92630