Sr Assoc Gen Counsel Hlthcare

Profile We offer remote work opportunities (AK, AR, AZ, CO, FL, HI, IA, ID, IL, KS, LA, MD, MN, MO, MT, NE, NV, NM, NC, ND, OK, OR, SC, SD, TN, TX, UT, VA/DC, WA, WI & WY only). This position is remote but Phoenix area preferred. Our Department of Defense contract requires US citizenship and a favorably adjudicated DOD background investigation for this position. Veterans, Reservists, Guardsmen and military family members are encouraged to apply! Job Summary Reporting to the Deputy Chief Compliance and Legal Officer (“DCCLO”), this senior position is the lead attorney responsible for developing the Company’s legal strategy related to all areas directly impacting healthcare. Further, the candidate is a key business partner to the Chief Network Officer and leaders of the Provider Services, Medical Management and Claims teams, providing not only legal advice but also applying judgment and business expertise on approaching the many difficult issues their respective teams face. Provides leadership over the legal advice and counsel provided to TriWest’s healthcare-related departments; oversees and supervises attorneys and staff and manages the allocation of work in support of the healthcare law space. The candidate will be responsible for developing best-in-class provider contracts and related documents and may often take a lead role in negotiating significant network subcontractor agreements. Direct report(s) will draft, review and participate in negotiating contracts with providers and other organizations with a goal of achieving acceptable risk levels. The candidate will be the lead attorney for the Company also in providing advice and guidance on regulatory healthcare matters, including Medicare and Medicaid and conditions of participation in federal healthcare programs, anti-kickback laws, self-referral laws and HIPAA, fraud and abuse, and corporate and transactional matters for health care providers. Education & Experience Required: • Juris Doctor degree from an accredited law school • 15+ years’ legal experience as an Attorney in healthcare law or related field • U.S. Citizen • Must be able to receive a favorable interim and adjudicated final Department of Defense (DoD) background investigation • Excellent written and verbal communication skills • Experience advising managed care administrators, health plans, or healthcare providers • Familiarity with HIPAA, False Claims Act, Stark, Anti-Kickback and other healthcare-related laws & regulations Preferred • Familiarity with government-funded healthcare programs • Familiarity with VA and DoD healthcare programs • Prior experience with federal government contracting Key Responsibilities • Serves as strategic lead of the Healthcare Law unit within the TriWest legal function; developing and implementing the Company’s legal strategy for the healthcare space. Plans the work of the unit, implementing the priorities, assigning work, hiring, supervising and evaluating unit staff to assure outstanding legal representation. • Provides leadership/ownership of Healthcare Law projects, coordinates support provided by the Healthcare Law unit, and builds a cohesive, supportive unit that works well with one another, develops objectives, and priorities. • Serves as the primary legal business partner to the Chief Network Officer as well as leaders in Providers Services, Medical Management, and Claims. • Manages and mentors staff, guides professional development, including coaching and direction to direct reports; manages direct report performance; establishes best-practices for the Healthcare Law area. • Reports to DCCLO regarding legal risks and issues related to healthcare law encountered by the healthcare legal team. • Manages the healthcare related litigation portfolio, including litigation supported by outside counsel. • Identifies and analyzes legal issues (including conducting legal research, identifying new or emerging areas of risk, etc.), presents clear recommendations, and ensures legal compliance. • Ensures that Company employees and committee members are aware of and in compliance with applicable laws and regulations. • Reviews and develops documents and contracts as necessary including provider agreements, business associate agreements, transactions involving electronic health records, telehealth, and others as needs arise. • Assists in providing legal advice to departments and committees throughout TriWest on all health law issues, including fraud and abuse, privacy and security, and peer review privilege. • Drafts and reviews other miscellaneous legal documents and correspondence. • Researches current issues and developments related to government healthcare programs, health insurance and impact of existing and proposed healthcare regulations. • Performs legal research and prepares memoranda as required. • Assists with the development and monitoring of internal regulatory compliance procedures. • Reviews responses to grievances, routine and priority correspondence, and internal and external communications documents. • Functions on and/or assigns coverage to TriWest standing and ad hoc committees as a representative of the Legal department including, but not limited to, committees responsible for TriWest’s peer review, quality, and credentialing programs. • Assists with TriWest training and implementation to ensure legal compliance with requirements. • Reviews and revises Company policies and procedures. • Advises TriWest senior leadership of the legal ramifications of past and proposed company actions. • Performs other duties as assigned. • Regular and reliable attendance is required. Competencies Coaching / Training / Mentoring: Actively foster actions required for desired business outcomes through ongoing constructive feedback. Communication / People Skills: Ability to influence or persuade others under positive or negative circumstances; adapt to different styles; listen critically; collaborate. Computer Literacy: Ability to function in a multi-system Microsoft environment using Word, Outlook, TriWest Intranet, the Internet, and department software applications. Coping / Flexibility: Resiliency in adapting to a variety of situations and individuals while maintaining a sense of purpose and mature problem-solving approach is required. Empathy / Customer Service: Customer-focused behavior; helping approach, including listening skills, patience, respect, and empathy for another's position. Independent Thinking / Self-Initiative: Critical thinker with ability to focus on things which matter most to achieving outcomes; commitment to task to produce outcomes without direction and to find necessary resources. Information Management: Ability to manage large amounts of complex information easily, communicate clearly, and draw sound conclusions. Leadership: Successfully manage different styles of employees; provide clear direction and effective coaching. Organizational Skills: Ability to organize people or tasks, adjust to priorities, learn systems, within time constraints and with available resources; detail-oriented. Problem Solving / Analysis: Adept at developing strategic legal strategy for healthcare-related areas. Ability to solve problems through systematic analysis of processes with sound judgment; has a realistic understanding of relevant issues. Technical Skills: Proficiency in Microsoft Office (Word, Excel, Outlook, Power Point). Working Conditions Working Conditions • Availability to work non-regular hours as necessary • Works within a standard office environment, with minimal travel • Extensive computer work with prolonged periods of sitting TriWest job postings typically include a salary range, which can vary based on the specific role and location, but generally this position ranges from around $247,500 to $275,000 per year. Company Overview Taking Care of Our Nation’s Heroes. It’s Who We Are. It’s What We Do. Do you have a passion for serving those who served? Join the TriWest Healthcare Alliance Team! We’re On a Mission to Serve®! Our job is to make sure that America’s heroes get connected to health care in the community. At TriWest Healthcare Alliance, we’ve proudly been on that important mission since 1996. Benefits We’re more than just a health care company. We’re passionate about serving others! We believe in rewarding loyal, hard-working people who are willing to learn as they grow. TriWest Healthcare Alliance values teamwork. Join our team, fulfill your responsibilities, and you may also be considered for frequent pay raises, overtime opportunities to earn even more, recognition and reward programs, and much more. Of course, we also offer a comprehensive and progressive compensation and benefits package that includes: • Medical, Dental and Vision Coverage • Paid time off • 401(k) Retirement Savings Plan (with matching) • Short-term and long-term disability, basic life, and accidental death and dismemberment insurance • Tuition reimbursement • Paid volunteer time Equal Employment Opportunity TriWest Healthcare Alliance is an equal employment opportunity employer. We are proud to have an inclusive work environment and know that a diverse team is a strength that will drive our success. To that end, TriWest strives to create an inclusive environment that supports diversity at every organizational level, and we highly encourage candidates from all backgrounds to apply. Applicants are considered for positions based on merit and without discrimination on the basis of race, color, religion, sex, sexual orientation, gender identity, national origin, age, disability or any other consideration made unlawful by applicable federal, state, or local laws. Apply tot his job Apply To this Job