Associate General Counsel III, Provider Contracting
About The Position
Medica is seeking to hire an Associate General Counsel III to join our Legal Department and support our Provider Network contracting team. Our General Counsel provides legal advice and services on issues concerning the rights, obligations, and privileges of the organization. This role will protect the organization's rights in contract negotiations, settlements and dispute resolution, and provide a full range of legal advice and services and may specialize in one of more areas of law: insurance, health, government programs, commercial, contracts, benefit, anti-trust investigations, tax law, regulatory and compliance. Performs other duties as assigned.
Requirements
- J.D. degree from an ABA-accredited law school and a current license to practice law in at least one United States jurisdiction
- 5+ years of work experience beyond degree
- Contract experience and negotiation experience
- Strong Project Management skills – able to organize, document, manage and improve complex department processes, workflows, and shared resources
- Excellent writing, editing, and proofreading skills and experience working with contracts, templates or other legal documentation to include review, interpretation, editing, creation.
- Well-developed analytical and problem-solving skills
- Able to independently analyze complex business issues and provide solution recommendations based on an accurate interpretation of the law
- Situationally aware, able to apply consistent judgment to seek decision support from their manager and or the legal team
- Will be required to leverage the expertise of Medica department leads, this position needs to build strong working rapport with internal and external teams
- Maintains focus on time sensitive deliverables and under sometimes stressful circumstances and rapid changes in demand, can appropriately re-prioritize tasks and projects
- Must be legally authorized to work in the United States at the time of application.
Nice To Haves
- Experience within the healthcare, health insurance or insurance industry. Experience from heavily regulated industries such as banking, financial services, etc. will also be considered.
- Knowledge of ERISA and HIPAA preferred
- Experience building and maintaining a rapport with internal clients and external business partners
Responsibilities
- Draft provider contract templates, amendments, including value-based payment provisions
- Be the first point of contact for Network contract managers with provider contract template questions and requests for assistance with counterproposal language
- Negotiate directly with provider legal counsel
- Give legal support for provider quality of care and FWA investigations and regulatory complaint responses involving providers
- Advise and engage in dispute resolution on claims payment issues with providers
- Research State/Federal laws, regulations, and sub-regulatory guidance
Benefits
- competitive medical, dental, vision, PTO, Holidays, paid volunteer time off, 401K contributions, caregiver services
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What This Job Offers
Job Type
Full-time
Career Level
Mid Level
Education Level
Ph.D. or professional degree
