Bethesda, MD, United States
Nov 17, 2021
Integrated Healthcare Delivery Regulatory Counsel
The Senior Counsel provides a full range of legal advice and services on issues related to the operations of an integrated health care system, and will be expected to work on issues of diverse scope and complexity.
The Senior Counsel position is for an attorney who will provide strategic advice and counsel on operational and regulatory matters, and provide guidance on issues arising in the day-to-day functionality of Humana's integrated healthcare delivery model with a focus on supporting the company's Home Solutions line of business. In this role the attorney will be expected to provide legal advice to business and clinical staff leadership regarding relationships with payors, including Medicare Advantage organizations, as well as other health care providers and entities. This will require a fluent understanding and expertise in a wide range of health law areas. A strong preference will be given for someone with substantive experience in counseling home health agencies.
The attorney will be expected to use knowledge and experience in exercising independent judgment and decision making on the applicability of federal and state healthcare laws and regulations related to clinical, strategic, and business operations. The attorney will also assist in the preparation and review of various transactions, agreements, and other documents. The attorney should possess substantial knowledge and have practical experience with legal issues commonly seen by providers in both the clinic and home setting, including, but not limited to: clinical policies and procedures, billing and claims processing issues, licensure requirements, Medicare Conditions for Coverage and Conditions of Participation, and Fraud, Waste, and Abuse laws including Stark, Anti-kickback, and prohibitions against beneficiary inducement. This role requires the ability to simultaneously organize, manage, and prioritize projects for multiple internal clients, while working with senior members of the law department on implementing strategy and processes. This attorney will work closely with other attorneys supporting Humana's clinical business areas and integrated care delivery strategy and will report directly to the Associate VP / Assistant General Counsel on the team.
Juris Doctor degree from an ABA accredited law school
Active membership in a state bar association
Minimum of 7 to 10 years of combined experience in: a healthcare practice of a law firm, and an academic or multi-state integrated healthcare system or home health network
Strong organizational skills involving diverse matters and clients
Strong skills in communicating legal issues to various stakeholders
Ability to work independently under general supervision
Substantive experience in advising home health agencies either as part of an in-house law department or as part of law firm's healthcare practice.
This can be a remote position provided there is flexibility to travel to Louisville, Boston, and Miami, as needed.
For this job, associates are required to be fully COVID vaccinated or undergo weekly COVID testing and wear a face covering while at work. The weekly testing will need to be done through an approved Humana vendor, and unvaccinated associates should follow all social distancing and masking protocols if they are required to come into a Humana facility or work outside of their home. We are a healthcare company committed to putting health and safety first for our members, patients, associates, and the communities we serve.
If progressed to offer, you will be required to:
Provide proof of full vaccination OR
Commit to weekly testing, following all CDC protocols, OR
Provide documentation for a medical or religious exemption consideration.
This policy will not supersede state or local laws. Requests for these exemptions should be submitted at least 2 weeks prior to your scheduled first day of work.
Scheduled Weekly Hours