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Years of Experience
Date Last Verified
National Health Care Provider Practice Group Lead, Senior Corporate Counsel The candidate will support company's regional and state lawyers and business clients across company's growing national footprint. Will report to the Vice President, Assistant General Counsel, Litigation, Regulatory and Health Plan Operations. Position will involve extensive contact with senior management and with representatives of the business units and corporate functions across the organization in multiple offices. Support company's regional/state lawyers and business clients across the US on all aspects of provider contracting, including ensuring compliance with government program rules applicable to provider relationships. Provide legal counsel on federal and state regulatory regimes applicable to provider relationships. Support strategic company-provider partnerships and alliances (e.g., ACOs). Provide legal advice around economic initiatives impacting providers. Monitor and report on relevant developments and trends. Assist where needed on provider disputes and litigation, including payments, credentialing and terminations. Facilitate a cross-functional internal Legal practice group of subject matter experts on a range of provider-related issues.
Qualification and Experience
The candidate must have strong academic credentials and 10+ years of legal experience, heavily focused on health care provider issues, including sophisticated contracting, strategic partnerships/ACOs, payment systems and quality, medical economics and regulatory and reporting regimes applicable to provider relationships (e.g., prompt pay, anti-kickback, etc). Experience in this capacity with or on behalf of a multi-market MCO, and government programs experience, strongly preferred. Should be a member in good standing of a relevant State Bar. Strong financial acumen related to MCO and provider payment model economics is also strongly preferred. Periodic travel may be required.
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