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Senior Corporate Counsel - Health Plans / Commercial The candidate will be responsible for drafting and negotiating a wide range of commercial contracts, with a concentration on provider and health plan agreements. Will lead legal negotiations with the customers and advise the Commercial team on the establishment of strategic relationships and driving profitable growth with health plans. Working closely with Vice President of Health Plans/Payors, s/he will handle a wide range of legal responsibilities under the supervision of the Assistant General Counsel, including participating in business, operational and strategic decisions; advising leadership of Health Plans on strategies, opportunities, issues and risk management; developing and negotiating third party payer arrangements, including government payer programs such as Medicare and Medicaid, advising on provider network development and contracting, and managing general health plan legal matters including regulatory and compliance matters. Act as a strategic partner for the Vice President of Health Plans in the establishment of the groups organizational goals. Analyze and develop strategies and problem solving with clients, Compliance and Government Affairs. Work with billing and clinical franchises to support strategic opportunities to improve pricing and/or coverage. Counsel clients on a range of business and legal regulatory issues, including STARK and fraud and abuse laws. Develop training for clients and perform training for assigned areas. Should have 7+ years of expertise in healthcare business law is required; experience with Health Plans is desired. Must have experience in health plan operations, regulatory compliance, legal issues relating to insurance law, interpretation of various types of insurance policies. Requires the ability to lead and influence leaders on areas within subject matter expertise. Skills and expertise in health plans and insurance industry required. Requires energy and interest in keeping up to date on ever-changing rules and regulations that apply to health care providers and health plans. Requires excellent language and writing skills in order to draft, edit and develop contract language, policies, procedures, workforce training materials, web-based resources and other documentation. Must be duly licensed to practice law. Strong educational background including an undergraduate degree and JD are required. Strong corporate, commercial or transactional experience required. Should have an understanding of how to support the achievement of business objectives while considering the regulatory landscape.
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