Managed Care Counsel
A large, highly regarded integrated health system in the Mid-Atlantic is seeking a Managed Care & Revenue Cycle Counsel to join its in-house legal team. This is a high-impact role sitting at the intersection of payer strategy, reimbursement, and operational performance across a complex provider network.
This position will play a critical role in supporting financial sustainability initiatives, optimizing managed care relationships, and advising on reimbursement strategy in an increasingly dynamic healthcare environment.
Responsibilities:- Serve as the primary legal advisor to managed care and revenue cycle leadership, supporting contracting strategy, reimbursement optimization, and payer engagement
- Lead the negotiation, drafting, and interpretation of managed care agreements across commercial payors, Medicare Advantage plans, and Medicaid MCOs
- Provide guidance on revenue cycle operations, including billing, coding, denials management, and collections
- Partner with finance, compliance, and operational stakeholders to identify risk, enhance reimbursement performance, and drive margin improvement
- Advise on escalated matters involving underpayments, recoupments, audits, and payer disputes
- Monitor and interpret regulatory developments impacting reimbursement, value-based care, and payer-provider dynamics
Requirements:
- J.D. with active bar membership
- 5-10+ years of experience in healthcare law with a focus on managed care, reimbursement, or revenue cycle
- Strong experience with payer contracting and reimbursement frameworks (commercial, Medicare, Medicaid)
- Background supporting providers, health systems, or payors on complex reimbursement and operational matters
- Business-oriented mindset with the ability to deliver practical, solution-driven legal guidance
- Collaborative, high-performing professional who thrives in a fast-paced, cross-functional environment
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