VP & Associate General Counsel, Clinical Operations

Humana•Seattle, WA

About The Position

Become a part of our caring community and help us put health first Position Summary: The Vice President & Associate General Counsel – Clinical Operations is a key member of the leadership team of the Law Department, responsible for advising the Company’s care delivery lines of business under the CenterWell umbrella: CenterWell Primary Care, CenterWell Home Health, and Onehome. This role requires working independently at a law firm partner level in collaboration with other internal and external counsel. Success in the role requires the ability to thrive in a collaborative and dynamic environment and effectively partner across law, compliance, enterprise risk management, government affairs and business operations teams. Location: Louisville, KY; Washington, D.C.; Chicago, IL

Requirements

Juris Doctor (JD) from an accredited law school; licensed to practice law in relevant jurisdiction.
Minimum of 15 years of legal experience, including significant experience in primary care, home care or clinical delivery operations.
Exceptional communication, negotiation, and organizational skills.
Proven ability to manage complex projects and influence at the executive level.

Nice To Haves

Prior in-house counsel experience preferred.
Legal expertise: A strong background in healthcare law, including experience with corporate governance, compliance, and risk management.
Business acumen: Strategic thinker with the ability to understand how the business operates and to provide strategic legal advice that aligns with business goals.
Communication and negotiation: Strong skills in drafting, negotiation, and clear communication with both legal and non-legal stakeholders.
Industry knowledge: Familiarity with the specific healthcare industry the company operates in, whether it's pharmaceuticals, a hospital system, or healthcare technology.
High integrity and sound judgment.
Embrace change management and rethinking existing processes.

Responsibilities

Lead the work of the Clinical Operations team in the Law Department (including lawyers, paralegals and other professionals across multiple offices), advising business colleagues on legal matters relating to the operations of the Company’s senior-focused primary care and home care businesses.
Provide guidance and advice with respect to a variety of issues related to the delivery of healthcare services, including: anti-kickback, Stark Law and other fraud, waste and abuse laws & regulations professional practice issues, including corporate practice of medicine, scope of practice laws, licensure, medical board disciplinary actions, and quality, patient safety, and peer review matters wide variety of contracting matters, including payor, accountable care organization (ACO), independent physician association (IPA) and value-based care arrangements for primary care and home health services Medicare billing, enrollment, and conditions of participation rules coding/reimbursement and revenue cycle management assisting in compliance reviews of clinical operations
Coordination with, and provision of subject matter expertise to, other internal teams to respond to governmental or payor investigations relating to primary care or home health care delivery participate in diligence review and integration of mergers & acquisitions coordinate with Humana privacy and HIPAA teams to address patient consent and privacy and security matters
Extensive interaction with C-Suite and other senior executives to counsel on these matters and participate in briefings to the Board of Directors or Committees of the Board on material matters and developments.
Serve as a key leader in the company’s Law Department, helping with department management, including organization and structuring, talent evaluation, management and rationalization, budgeting decisions, and strategy.

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