Assistant General Counsel - Health Care Regulatory The candidate will perform regulatory work with focus on fraud and abuse, reimbursement, and provider relationships. Provide general healthcare advice on compliance, regulatory and physician relationship issues, including advice on Beneficiary Inducement, Stark, Anti-Kickback, and physician entities. Provide reimbursement counsel to the revenue operations, payor contracting and insurance management teams, including leading efforts on appeals and audit responses. Provide regulatory counsel to the executive teams. Coordinate with other legal groups on regulatory, risk, compliance and operational issues. Provide accurate updates and reporting on organizational risks to managers. Ability to handle legal and administrative work, help on management processes. Monitor changes in relevant regulatory areas and provide education on those changes to both operational and support functions. Manage outside counsel.
An undergraduate degree and a JD from an accredited law school is required. Must be admitted to practice law in at least one state. Should have Significant experience with Medicare/Medicaid requirements and reimbursement, health care regulatory issues, including experience with health care fraud and abuse laws and regulations, licensure and certification, contracting. Must have 4-10 years of experience focused on healthcare regulatory matters, with a major law firm and/or a mid-to-large size healthcare company's legal department highly preferred. A proven track record of providing regulatory advice and counsel working with members of a business and corporate professionals is required. Should have experience advising management and supporting regulatory efforts as a business partner with a deep understanding of the business. Recognized as a diligent professional who is a strong attorney but maintains a clear view on the need for productive ongoing relationships with the businesses. Must have ability to advise on risk while understanding business exigencies. Should have strong research and analytical skills, and the ability to manage several matters at once.
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