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Job Details

Deputy General Counsel - Contracting

Location
Dayton, OH, United States

Posted on
May 21, 2020

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Profile

Description
Role and Responsibility:
Reports to and assists the General Counsel in assigned tasks
Responsible for leading the team responsible for reviewing vendor and delegate contracts
Provide legal advice on a wide range of corporate matters, with an emphasis on vendor and delegate contracting for managed care and federal/state health care programs (Medicaid, Medicare, Marketplace/Exchange)
Provide day-to-day legal advice to ensure compliance with applicable laws, regulations, policy, Medicare, Medicaid, Marketplace/Exchange and accreditation standards
Represent **MEMBERS ONLY**SIGN UP NOW***. in structuring and negotiating corporate transactions such as mergers, acquisitions, affiliations, and joint ventures
Draft and negotiate managed care contracts, including provider agreements, health network contracts, administrative services agreements, service level agreements/performance guarantees, management agreements, vendor contracts, and reinsurance agreements
Assist with the oversight and monitoring of vendors and delegates related to contract compliance and regulatory compliance
Assist business partners in negotiating settlement related to contract disputes
Interface with regulators, including providing assistance in drafting regulatory filings and communications for submission to regulators and attending meetings with regulators
Conduct legal research and render opinions on legal matters, such as fraud and abuse issues, privacy, tax-exemption matters, legislation, and insurance regulations
Give presentations to governing boards, management committees, and workgroups
Draft policies and procedures needed by **MEMBERS ONLY**SIGN UP NOW***. to ensure that business operations are compliant with internal and external requirements
Advise **MEMBERS ONLY**SIGN UP NOW***. as to regulatory reporting requirements (data bank, state licensing board, Office of Inspector General, Centers for Medicaid and Medicaid Services, Medicaid agency, and department of insurance, etc.
Prepare and review contracts and/or agreements between the company and outside organizations with heavy emphasis on Managed Medicaid, Medicare Advantage/Part D, Marketplace (Federal Progams), as well as IT and delegated vendor contracts
Provide legal advice on a wide range of topics related to health care law such as, HIPAA, regulatory compliance, Medicaid and Medicare issues and privacy rights
Interact with management team as well as with external representatives of the legal system, regulatory agencies, governmental entities and others
Perform due diligence on any new state operations, including qualifying each company in a new state for business operations
Perform any other job related instructions, as requested
Requirements
Education / Experience:
Completion of a Juris Doctorate degree program from an accredited college/university is required
Minimum of five (5) years managed care experience, and/or related health care industry is required
Prior experience with Medicaid Managed Care or Medicare Advantage/Part D is required. Marketplace/Exchange experience is preferred
At least 5 years of vendor contracting experience required. Prior experience managing a vendor contracting team is strongly preferred
Required Competencies / Knowledge / Skills:
Advanced expertise in contract drafting, review, and negotiations
Advanced expertise in managed care is required. Managed Medicaid and Medicare Advantage/Part D experience are strongly preferred
Strong interpersonal skills and problem solving required – must be a self-starter and have a vision for vendor/delegate contracting
Top analytic, research and organizational skills
Advanced legal research and writing experience are required
Advanced Microsoft Office skills, including Word
Broad internet research experience
Superior written and oral communication capabilities are required
Strong customer service and team orientation
Excellent time/project management and prioritization are required
Ability to excel in fluid, dynamic environment
Licensure / Certification:
Must be a licensed attorney in good standing with a State Bar. A current, unrestricted license to practice law is required and proof of licensure and good standing is required at all times
Working Conditions:
General office environment; may be required to sit/stand for long periods of time
This job description is not all inclusive. **MEMBERS ONLY**SIGN UP NOW***. reserves the right to amend this job description at any time. **MEMBERS ONLY**SIGN UP NOW***. is an Equal Opportunity Employer, including disability and veteran status. We are committed to a diverse and inclusive work environment.

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