Overview
Remote work is available for this role in AK, AR, AZ, CO, FL, HI, IA, ID, IL, KS, LA, MD, MN, MO, MT, NE, NV, NM, NC, ND, OK, OR, SC, SD, TN, TX, UT, VA/DC, WA, WI & WY only.
This position is supported by a Department of Defense contract and requires U.S. citizenship and a favorably adjudicated DOD background investigation.
This role provides legal counsel to healthcare-related departments, including Provider Services, Medical Management, Program Integrity, and Claims.
Responsibilities
- Identify and analyze legal issues, including conducting legal research and identifying new or emerging areas of risk; present clear recommendations and ensure legal compliance.
- Investigate, research, and provide general legal advice across a broad range of issues arising from organization operations.
- Draft, review, and participate in negotiating contracts with providers and other organizations to help achieve acceptable risk levels.
- Review and develop legal documents and contracts, including:
- Provider agreements
- Business associate agreements
- Transactions involving electronic health records
- Telehealth agreements and other materials as needs arise
- Provide legal advice to departments and committees on health law issues, including fraud and abuse, privacy and security, and peer review privilege.
- Draft and review miscellaneous legal documents and correspondence.
- Research current issues and developments related to government health care programs, health insurance, and the impact of existing and proposed healthcare regulations.
- Prepare legal memoranda on other assigned legal issues.
- Assist with the development and monitoring of internal regulatory compliance procedures.
- Review marketing materials, responses to grievances, routine and priority correspondence, and internal and external communications documents.
- Serve on standing and ad hoc committees as a representative of the Legal department, including committees responsible for peer review, quality, and credentialing programs.
- Assist with training and implementation activities to ensure legal compliance with requirements.
- Review and revise policies and procedures.
- Ensure employees and committee members are aware of and comply with applicable laws and regulations.
- Educate staff and committee members on legal requirements as appropriate.
- Advise senior leadership on the legal ramifications of past and proposed actions.
- Perform other duties as assigned.
- Maintain regular and reliable attendance.
Requirements
- Juris Doctor degree from an accredited law school
- License to practice law in the state where legal services will be primarily provided
- 4+ years’ legal experience in healthcare or related field
- Excellent written and verbal communication skills
- Experience advising managed care administrators, health plans, or healthcare providers
- Familiarity with HIPAA, False Claims Act, Stark, Anti-Kickback, and other healthcare-related laws & regulations
Preferred Qualifications
- Familiarity with government-funded healthcare programs
- Familiarity with VA and DoD healthcare programs
- Prior experience with federal government contracting
- Experience reviewing, drafting, and negotiating commercial contracts, including technology agreements
- Experience in fraud and abuse work
- Experience with corporate and transactional matters for health care providers
Working Conditions
- Availability to work non-regular hours as necessary
- Standard office environment with minimal travel
- Extensive computer work with prolonged periods of sitting
Compensation & Benefits
- Salary range (varies by role and location): generally $209,000 to $233,000 per year.
- Medical, Dental and Vision Coverage
- Paid time off
- 401(k) Retirement Savings Plan (with matching)
- Short-term and long-term disability, basic life, and accidental death and dismemberment insurance
- Tuition reimbursement
- Paid volunteer time
- Additional compensation elements may include frequent pay raises, overtime opportunities, and recognition/reward programs
Equal Employment Opportunity
The organization is an equal employment opportunity employer and considers applicants for employment based on merit without discrimination on the basis of race, color, religion, sex, sexual orientation, gender identity, national origin, age, disability, or any other legally protected status.