Assistant Counsel - Jefferson Health Enterprise

Job Details

As a member of the Enterprise Office of Legal Affairs (EOLA), provides legal input and advice to Thomas Jefferson University's and/ or Jefferson Health Plans's insurance business lines, including each HMO and licensed insurer comprising Jefferson Health Plans and their associated departments, divisions and business units, in connection with all areas pertaining to health plan operations and initiatives, associated contracts, transactions, regulatory matters, and operational issues, across a variety of legal practice areas. Conducts primary review of legal documents in a variety of legal practice areas, with focus on general health plan operations, managed care contracting, first-tier entities, subcontractor and vendor contracting, and general commercial and purchasing transactions. Position will directly and independently interface extensively with executives, business persons, and regulatory authorities.

Job Description

• Drafts, reviews, revises and negotiates legal documents associated with health plan operations, including managed care contracting, first tier entities, subcontractor and vendor contracting, general commercial and purchasing transactions and other operational functions, in all cases to ensure that business objectives are achieved and the contract terms and conditions are in accord with the various rules and regulations under which Jefferson operates.
• Works closely with EOLA and enterprise leadership to understand strategic initiatives and business needs and to articulate appropriate legal considerations and risk analyses, which must be appropriately taken into account in decision-making.
• Identifies novel and/or unresolved legal issues, disputes and trends, and collaborates with other EOLA attorneys for resolution. Provides related education and advice to executive leaders as needed.
• Participates in EOLA efforts to create and disseminate template documents for a variety of business functions.
• Uses and supports the administration of legal service request, matter management, document management and other systems deployed by EOLA, to ensure compliance with policies and procedures and regulatory requirements for contract processing, management, negotiations and maintenance/repository of contracts.
• Independently cultivates and manages client relationships with Jefferson stakeholders and business relationships with external parties.
• Participates and attends relevant committees and meetings at Jefferson locations, as instructed.
• Supports EOLA team members and personnel on other legal matters, as needed.
• Interacts with co-workers, visitors and other staff consistent with the values of Jefferson.
• Performs other tasks, as assigned by EOLA.

Education and Experience:

• Juris Doctor from an ABA-accredited school.
• 5 years of experience as a business or health care lawyer with demonstrated experience in directing, managing and negotiating commercial contracts and transactions and advising on regulatory matters.
• Membership in good standing with the Pennsylvania and/or New Jersey bar or bar membership in another U.S. jurisdiction with the ability to obtain a Pennsylvania or New Jersey Limited In-House Counsel License.
• Health care regulatory law experience is required, as is an excellent understanding of major federal laws, applicable state laws and related regulations that govern the provision of not-for-profit health care services.
• Demonstrated experience with health care contracting, provider and payor relationships, and applicable regulatory frameworks, including health care fraud and abuse laws and regulations, licensure and certification, healthcare information systems, and Medicare/Medicaid program requirements and reimbursement.
• ATTY - Licensed Attorney - State of Pennsylvania or
• ATTY - Licensed Attorney - State of New Jersey
• Background in health plan and regulated insurance industry, with in-house legal department experience and/or in-house health plan experience preferred.

 

Work Shift

Workday Day (United States of America)

Worker Sub Type

Regular

Employee Entity

Thomas Jefferson University

Primary Location Address

1101 Market, Philadelphia, Pennsylvania, United States of America

Nationally ranked, Jefferson, which is principally located in the greater Philadelphia region, Lehigh Valley and Northeastern Pennsylvania and southern New Jersey, is reimagining health care and higher education to create unparalleled value. Jefferson is more than 65,000 people strong, dedicated to providing the highest-quality, compassionate clinical care for patients; making our communities healthier and stronger; prepa