Senior Counsel, Managed Care

Nashville, TN

POSITION SUMMARY:

This position offers significant responsibility, exposure and variety for a candidate with senior level experience. The candidate will have the opportunity to interact with multiple members of Tenet’s legal, managed care and senior management teams, as well as outside counsel.

Additionally, the individual must be able to communicate well with the other team members, ask good questions, collaborate with various internal stakeholders and, at times, work independently. The individual must alsobe willing to work in a high-pressure, fast-paced environment and have the ability to juggle multiple projects at one time.

Specific requirements include the following:
  • A minimum of five years of experience in complex managed care litigation and arbitration management in a leading managed care company or an integrated healthcare delivery system (either for-profit or not-for-profit).
  • Prior experience as a senior associate or partner of a national healthcare law firm is preferred.
  • Superior contract drafting and negotiation experience is essential, including the negotiation of complex multi-year contracts.
  • Familiarity with the regulatory framework of health plans, including a working knowledge of the federal and state insurance laws impacting plans in states which Tenet currently provides care, including California, Arizona, Texas, and Florida.
  • Familiarity with regulation and operations of hospitals, ambulatory surgery centers, and standalone emergency rooms, urgent care centers, and other outpatient provider models.
  • Familiarity with statutory and regulatory compliance issues arising under the Affordable Care Act, including issues regarding health insurance exchanges, Essential Health Benefits, transparency, medical loss ratios (MLRs), internal and external claims review, IRO’s, Accountable Care Organizations (ACOs), and network adequacy., and.
  • General familiarity with other healthcare regulations, including HIPAA (privacy, security, and standard transactions); Medicare Advantage (Part C), Medicare secondary payor; Anti-kickback and anti-inducement and the False Claims Act.
  • Demonstrated research, analytical, organizational and computer skills.

REQUIRED SKILLS:

Responsibilities Include

Tenet Healthcare Corporation is seeking to hire an experienced lawyer with a background in managed care/healthcare law and extensive contract negotiation skills to provide legal advice to the Company’s Managed Care team in connection with payer contract negotiations, contract disputes.

The core job functions include the following:

  • Comprehension of and contribution to the managed care legal strategy.
  • Responsible for oversight and supervision of managed care arbitration and litigation matters.
  • High level and detailed agreement drafting and negotiating.
  • Advising on regulatory matters as they relate to managed care contracts, disputes and strategy.

Professional and Personal Attributes

  • Must have strong communication skills, be extremely responsive and possess meticulous attention to detail and initiative.
  • Must be capable of negotiating and drafting in a high-energy paced team environment.
  • Must also possess excellent interpersonal and communication skills with the ability to brief individuals at all levels of the organization, including top executives and outside counsel, on complex contracting issues.
  • This position will involve handling confidential matters requiring the exercise of good judgment and discretion.
  • An individual of highest personal and professional integrity, principle, and knowledge, earning respect and support when making difficult decisions and choices.

Education/Certifications

Juris Doctor Degree from an ABA Accredited Law School and appropriate law license is required.

Compensation

A competitive compensation program will be tailored to the selected candidate. Base salary will be supplemented by a performance bonus and comprehensive, well-rounded benefits program, which includes relocation assistance.

Travel

Minimal.

Tenet Healthcare complies with federal, state, and/or local laws regarding mandatory vaccination of its workforce. If you are offered this position and must be vaccinated under any applicable law, you will be required to show proof of full vaccination or obtain an approval of a religious or medical exemption prior to your start date. If you receive an exemption from the vaccination requirement, you will be required to submit to regular testing in accordance with the law.

For more information and to apply, click here.

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