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General Counsel Consulting

General Counsel
Consulting
provided
exceptional
service in helping
my organization
recruit for a hard
to fill position.
They did extensive
work on the front
end to understand
our needs and
our culture and
began referring
highly qualified
candidates almost
immediately.

Melinda Burrows
Deputy General Counsel
- Litigation and
Compliance, Progress
Energy Service Company
LLC

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Counsel Jobs > Senior Counsel- Government Segment Regulatory Job in Connecticut > Senior Counsel- Government Segment Regulatory

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YOUR WINDOW TO A WORLD OF OPPORTUNITIES

Senior Counsel- Government Segment Regulatory

Refer job# VHVA151793

Senior Counsel- Government Segment Regulatory Responsibilities: Provide strategic legal regulatory advice and counsel to Government Business Segment products and services on Medicare Program Parts A, B, C, and D. Provide interpretative and practical advice regarding oversight and compliance requirements of the Medicare Advantage and Medicare Prescription Drug programs. Advise Government Business on compliance, risk adjustment; Star ratings; medical loss ratio and other financial and reporting requirements; internal investigations; fraud and abuse and managing government disclosures. Serve as lead lawyer for in responding to government audits and investigations. Serve as subject matter expert on federal health care laws and regulation, regulatory and enforcement environment affecting the business, including federal and state anti-kickback and self-referral laws, fraud and abuse, False Claims Act liability, government payor billing and reimbursement requirements and payment, government audits, and compliance programs. Advises on the development of business arrangements to assure compliance with federal and state fraud and abuse laws, including the discount, managed care and group purchasing organizations safe harbors. Collaborates with the business team and enterprise colleagues on the impact and response to proposed and new rules, regulations and legislation. Work closely with business Operations and Compliance to identify and reduce known and potential regulatory, legal and business risks. Design and implement measures to avoid, reduce and mitigate risks. Qualifications: JD Degree from accredited law school/Bar membership required. 10+ years corporate legal department or law firm experience. Experience in government programs. Experience with managed care strongly preferred. Broad knowledge of federal health care programs and insurance industries. Strong analytical, written and oral communication skills, including negotiation skills. Interpersonal skills to develop and manage relationships with business clients at all levels. Strong ability to identify issues and propose actionable legal and business solutions. Uses a customer-focused and creative approach to problem solving and the ability to efficiently manage a substantial number of issues and competing priorities effectively. Strong ability to maneuver through business barriers to facilitate solutions. Exceptional track record of project and process management. Strong work ethic with effective time-management. Demonstrated good judgment and willingness to take on difficult projects. Experience in measuring and analyzing process, as well as results, to identify opportunities for improvement.

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