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Years of Experience
Date Last Verified
National Provider Corporate Counsel Lead The candidate will report to the VP Assistant General Counsel. Will 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 should have a J.D. degree from accredited law school. Must have 8+ years of legal experience, heavily focused on healthcare 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. Strong financial acumen related to MCO and provider payment model economics is also strongly preferred. Advanced knowledge of healthcare delivery is needed. Should be licensed to practice law in state of office residence or get licensed.
Ref. #: 1704589
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