Division Counsel – Compliance & Regulatory

Nashville, TN

Discover Vanderbilt University Medical Center:  Located in Nashville, Tennessee, and operating at a global crossroads of teaching, discovery, and patient care, VUMC is a community of diverse individuals who come to work each day with the simple aim of changing the world. It is a place where your expertise will be valued, your knowledge expanded, and your abilities challenged. Vanderbilt Health recognizes that diversity is essential for excellence and innovation. We are committed to an inclusive environment where everyone has the chance to thrive and where your diversity of culture, thinking, learning, and leading is sought and celebrated. It is a place where employees know they are part of something that is bigger than themselves, take exceptional pride in their work and never settle for what was good enough yesterday. Vanderbilt’s mission is to advance health and wellness through preeminent programs in patient care, education, and research.

Organization:

OLA (Legal Affairs) 10

Job Summary:

Vanderbilt Health – Executive Search Team is conducting a national search for a Division Counsel – Compliance & Regulatory Attorney with a strong regulatory and compliance background, including expertise in federal and state fraud, waste and abuse laws and related regulations, Medicare and Medicaid (TennCare) regulations and conditions of participation, and clinical research compliance. Significant experience counseling an Academic Medical Center or Teaching Hospital on compliance and regulatory issues is highly desirable. This position will carry the title of Division Counsel and will work directly with VUMC and within the Office of Legal Affairs, reporting to a Managing Counsel and the VUMC General Counsel.

Candidates must possess a minimum of 5 to 7 years of experience providing regulatory risk assessments and assistance with internal and/or external audits to health care providers and supporting and providing legal guidance to compliance teams.  Experience managing or responding to fraud, waste and abuse investigations and litigation is also desirable.  The successful candidate will have excellent oral and written communication skills, strong analytical, attention to detail and ability to address complex legal and compliance issues, and the ability to work independently within a dynamic and fast paced environment.  Excellent client management skills and the ability to prioritize competing demands will be necessary.

Position Shift: 1st shift; Days (Hybrid)

Role Accountabilities:

  • Partner with the Office of Compliance and Corporate Integrity to ensure the organization’s compliance with federal, stat and local healthcare laws and regulations, including but not limited to the Stark Law, Anti-kickback Statute, CMP, the Affordable Care Act and state specific healthcare laws.
  • Provide risk assessments and counsel on all aspects of compliance. with state and federal health care operations and billing laws and regulations, including federal and state fraud, waste and abuse laws.
  • Monitor changes in relevant regulatory areas and provide education on those changes to business and operational personnel and compliance and legal affairs teams.
  • Advise on Medicare and Medicaid (TennCare) contracting and payment issues, enrollment requirements, and conditions of participation.
  • Provide legal advice and assistance, including policy development and management support, on issues related to clinical trial billing, resident billing and ACGME and LCME issues, and physician compensation.
  • Assist the Division Counsel for Research in the review of and advice on research enterprise concerns, including effort reporting, grant accounting, clinical trials billing, and the application of the fraud, waste and abuse laws and regulations to sponsor-supplied equipment, medication and treatment supplies.
  • Provide regulatory support and assistance on contract and transaction matters in which VUMC may engage.
  • Consult with and provide assistance to other colleagues in the Office of Legal Affairs in a highly collaborative and team-oriented fashion.
  • Working knowledge of compliance issues applicable to Accountable Care Organizations, Clinically Integrated Networks, Medicare Shared Savings Programs, value-based healthcare initiatives.

Qualifications – External:

  • JD degree from an ABA accredited law school.
  • Must have at least five (5) years of directly applicable experience.
  • Employment contingent upon State of Tennessee licensure or registration and receipt of In-House Counsel Practice Certificate.  The successful candidate must also apply for and become licensed in the State of Tennessee within 12 months of employment or, if earlier, the date required under applicable rules of the Tennessee Supreme Court.

Preferred Qualifications:

  • Experience with Academic Medical Centers including faculty and health system issues.
  • Experience with policy development (drafting and revising policies).
  • Experience Guiding compliance programs.
  • Experience with clinically integrated networks.
  • Experience with Accountable Care Organizations
  • Experience with Medicare Shared Savings Programs.
  • Experience with Medicare contracting and payment issues.

For more information and to apply, click here.

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