Sr Assoc Gen Counsel Hlthcare

This position is remote but Phoenix area preferred. Remote work opportunities are available in AK, AR, AZ, CO, FL, HI, IA, ID, IL, KS, LA, MD, MN, MO, MT, NE, NV, NM, NC, ND, OK, OR, SC, SD, TN, TX, UT, VA/DC, WA, WI, and WY only. Our Department of Defense contract requires US citizenship and a favorably adjudicated DOD background investigation. Veterans, Reservists, Guardsmen, and military family members are encouraged to apply.

About the Role

Reporting to the Deputy Chief Compliance and Legal Officer (DCCLO), this senior position serves as the lead attorney responsible for developing the company’s legal strategy related to all areas directly impacting healthcare. The candidate is a key business partner to the Chief Network Officer and leaders of the Provider Services, Medical Management, and Claims teams, providing legal advice, judgment, and business expertise on complex issues. This role oversees and supervises attorneys and staff, managing the allocation of work in support of the healthcare law space. The candidate will develop best-in-class provider contracts and related documents and may lead negotiations for significant network subcontractor agreements. Additionally, this role serves as the lead attorney for regulatory healthcare matters, including Medicare, Medicaid, conditions of participation in federal healthcare programs, anti-kickback laws, self-referral laws, HIPAA, fraud and abuse, and corporate and transactional matters for healthcare providers.

Responsibilities

• Serve as the strategic lead of the Healthcare Law unit within the TriWest legal function, developing and implementing the company’s legal strategy for the healthcare space.
• Plan the work of the unit, assign priorities, hire, supervise, and evaluate unit staff to ensure outstanding legal representation.
• Provide leadership and ownership of Healthcare Law projects, coordinate support, and build a cohesive, supportive unit.
• Act as the primary legal business partner to the Chief Network Officer and leaders in Provider Services, Medical Management, and Claims.
• Manage and mentor staff, guide professional development, and establish best practices for the Healthcare Law area.
• Report to the DCCLO regarding legal risks and issues related to healthcare law.
• Manage the healthcare-related litigation portfolio, including litigation supported by outside counsel.
• Identify and analyze legal issues, conduct legal research, present clear recommendations, and ensure legal compliance.
• Ensure company employees and committee members are aware of and comply with applicable laws and regulations.
• Review and develop documents and contracts, including provider agreements, business associate agreements, and transactions involving electronic health records and telehealth.
• Provide legal advice on health law issues, including fraud and abuse, privacy and security, and peer review privilege.
• Draft and review miscellaneous legal documents and correspondence.
• Research current issues and developments related to government healthcare programs, health insurance, and healthcare regulations.
• Assist with the development and monitoring of internal regulatory compliance procedures.
• Review responses to grievances, routine and priority correspondence, and internal and external communications.
• Represent the Legal department on TriWest standing and ad hoc committees, including those responsible for peer review, quality, and credentialing programs.
• Assist with training and implementation to ensure legal compliance with requirements.
• Review and revise company policies and procedures.
• Advise senior leadership on the legal ramifications of past and proposed company actions.
• Perform other duties as assigned; regular and reliable attendance is required.

Requirements

• Juris Doctor degree from an accredited law school.
• 15+ years of legal experience as an Attorney in healthcare law or a related field.
• U.S. citizenship and ability to receive a favorable interim and adjudicated final Department of Defense (DoD) background investigation.
• Excellent written and verbal communication skills.
• Experience advising managed care administrators, health plans, or healthcare providers.
• Familiarity with HIPAA, False Claims Act, Stark, Anti-Kickback, and other healthcare-related laws and regulations.

Preferred Qualifications

• Familiarity with government-funded healthcare programs, including VA and DoD healthcare programs.
• Prior experience with federal government contracting.

Skills

• Coaching / Training / Mentoring: Actively foster actions required for desired business outcomes through ongoing constructive feedback.
• Communication / People Skills: Ability to influence or persuade others under varying circumstances; adapt to different styles; listen critically; collaborate.
• Computer Literacy: Ability to function in a multi-system Microsoft environment using Word, Outlook, TriWest Intranet, the Internet, and department software applications.
• Coping / Flexibility: Resiliency in adapting to a variety of situations and individuals while maintaining a sense of purpose and a mature problem-solving approach.
• Empathy / Customer Service: Customer-focused behavior; helping approach, including listening skills, patience, respect, and empathy for another's position.
• Independent Thinking / Self-Initiative: Critical thinker with the ability to focus on priorities to achieve outcomes; commitment to task without direction and ability to find necessary resources.
• Information Management: Ability to manage large amounts of complex information, communicate clearly, and draw sound conclusions.
• Leadership: Ability to manage different styles of employees; provide clear direction and effective coaching.
• Organizational Skills: Ability to organize people or tasks, adjust to priorities, learn systems within time constraints, and with available resources; detail-oriented.
• Problem Solving / Analysis: Adept at developing strategic legal strategy for healthcare-related areas; solve problems through systematic analysis with sound judgment and a realistic understanding of relevant issues.
• Technical Skills: Proficiency in Microsoft Office (Word, Excel, Outlook, PowerPoint).

Working Conditions

• Availability to work non-regular hours as necessary.
• Works within a standard office environment, with minimal travel.
• Extensive computer work with prolonged periods of sitting.

Pay

This position typically ranges from $247,500 to $275,000 per year.

Benefits

• Medical, Dental, and Vision Coverage.
• Paid time off.
• 401(k) Retirement Savings Plan (with matching).
• Short-term and long-term disability, basic life, and accidental death and dismemberment insurance.
• Tuition reimbursement.
• Paid volunteer time.
• Frequent pay raises, overtime opportunities, recognition, and reward programs.

About the Company

TriWest Healthcare Alliance is dedicated to taking care of our nation’s heroes by connecting them to healthcare in the community. Since 1996, we’ve proudly served those who served, fulfilling our mission to serve America’s veterans. We value teamwork and reward loyal, hard-working individuals who are willing to learn and grow.