Associate General Counsel - Pharmacy, Revenue Cycle, Payor Support

HonorHealth - 8125 N Hayden Rd, Scottsdale, AZ 85258. Hybrid role — 1-2 days in the office per week, Monday-Friday days.

About the role

Ideal candidates will have contracting experience in a hospital or health system setting, healthcare environment, or law firm specializing in managed care, pharmaceutical business (including 340B programs), with strong preference for hospital or health system experience. Experience negotiating terms and resolving disputes with managed care organizations related to reimbursement rates, utilization management, prior authorization procedures, network participation, and challenging denials of prior authorization requests for necessary medical treatments. Ensure organizational compliance with all relevant laws, regulations, and industry standards in managed care and pharmaceutical operations.

Responsibilities

• Provide primary legal support to designated areas on contract language, affiliations, labor and employment laws, leases, medical staff matters, and fraud and abuse analysis.
• Advise on strategic transactional matters, review and respond to claims, provide advice to staff, and revise policies to comply with federal and state requirements.
• Manage and coordinate with outside counsel on claims and transactions as needed.
• Research a broad range of laws and regulations affecting the organization, including healthcare facility operations, Medicare, Medicaid, fraud and abuse, Stark Law, Anti-Kickback Statute, antitrust issues, procurement, conflict of interest, compliance, tax-exempt issues, labor and employment, and affirmative action.
• Prepare legal memoranda as requested.
• Draft, negotiate, and review contracts and related documents for healthcare services, procurement, affiliations, confidentiality, physician employment, leases, software licenses, and electronic transmission of healthcare data.
• Provide general legal advice and direction to senior management, medical staff, leadership, and employees on operational issues, including patient-related situations.
• Oversee the work of legal professionals such as staff attorneys, paralegals, or coordinators.
• Perform other duties as assigned.

Requirements

• Doctorate (Juris Doctorate) required.
• 8 years of healthcare-related legal experience.
• Registered as an attorney with the Supreme Court of Arizona and licensed to practice in all Arizona courts and agencies, or licensed in another state with registration as in-house counsel in Arizona and full licensure within twelve months of hire.