Managed Care Counsel
A leading regional Health System in New York is looking to bring on Managed Care Counsel at the Associate General Counsel level. This role sits within the OGC and will play a key part in supporting enterprise-wide managed care strategy, working closely with internal stakeholders across contracting, revenue cycling, and business leadership matters.
In this position, you will serve as a strategic legal partner to the managed care function, advising on complex payor-provider relationships and driving initiatives tied to reimbursement, network strategy, and regulatory compliance.
Responsibilities:
- Provide legal counsel on managed care contracting, including drafting, negotiation, and interpretation of agreements with commercial payors, Medicare Advantage plans, and Medicaid managed care organizations.
- Advise on reimbursement structures, network participation, and payor-provider disputes, including escalation and resolution of complex issues.
- Partner closely with internal business teams (Managed Care, Revenue Cycle, Finance) to support contracting strategy and operational initiatives.
- Counsel on applicable healthcare regulations impacting managed care arrangements, including CMS requirements, the Affordable Care Act, No Surprises Act, and related state laws.
- Support due diligence and integration efforts related to affiliations, joint ventures, and system growth initiatives involving payor relationships.
Requirements:
- JD from an accredited law school and admission to at least one state bar.
- 5+ years of experience with managed care, payor-provider contracting, or healthcare regulatory matters (law firm and/or in-house).
- Demonstrated experience negotiating and advising on managed care agreements and reimbursement structures.
- Strong working knowledge of federal and state healthcare laws impacting payor arrangements (e.g., Medicare Advantage, Medicaid managed care, billing/reimbursement).
- Ability to operate as a business-facing attorney within a large, matrixed healthcare system.
This position is based in New York and offers the opportunity to work alongside a highly regarded legal team within a nationally recognized health system.
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