Associate General Counsel – Regulatory Affairs and Compliance

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 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 is committed to an environment where everyone has the chance to thrive and where your uniqueness 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:

The Vanderbilt Health Executive Search Team is conducting a national search for an Associate General Counsel – Regulatory Affairs and Compliance. The Associate General Counsel – Regulatory Affairs and Compliance provides a broad range of legal support to Vanderbilt Health’s operations serves as a key legal advisor supporting the academic medical center, regional hospitals, and affiliated healthcare entities. This attorney provides strategic and practical legal counsel regarding healthcare regulatory compliance, physician relationships, quality and value-based care initiatives, conflicts of interest, and clinically integrated network (CIN) operations. The position works closely with executive leadership, compliance, clinical enterprise, population health, quality, and operational stakeholders to manage legal and regulatory risk while advancing the organization's clinical, academic, and strategic objectives.

This role is responsible for collaborating with Vanderbilt Health departments and divisions, delivering timely legal guidance advising on compliance matters that impact Vanderbilt Health, and for collaborating as an active and engaged team member in support of the Office of Legal Affairs.

The successful candidate will be a strategic thinker, an approachable adviser, and a collaborative relationship-builder who thrives in an intellectually challenging environment and demonstrates alignment with Vanderbilt Health’s values.

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Shift: First Shift; Remote

General Responsibilities:

• Provide legal analysis and counsel on state and federal and compliance rules and regulations, including, without limitation, Physician Self-Referral Law (Stark), Anti-kickback Statute, Civil Monetary Penalties law, False Claims Act, Medicare and Medicaid reimbursement requirements.
• Provide support for healthcare reporting programs, including hospital inpatient and outpatient quality reporting, MACRA/MIPS and Alternative Pay models, other payor driven quality metrics.
• Provide advice on evolving federal and state regulatory requirements, interpret statutes, regulations and guidance impacting quality reporting obligations.
• Participate in compliance reviews, internal investigations, corrective action activities, and regulatory assessments.
• Provide support for conflict-of-interest disclosure process including review, analysis and resolution of potential conflicts involving employed and community physicians to ensure compliance with applicable regulatory requirements and organizational policies.
• Collaborate with compliance department to provide advice on federal and state regulatory requirements impacting Advanced Practice Providers including state licensing board, including compliance  risks related to expired or inadequate licensure, scope of practice misalignment, improper supervision, provide resolution strategies, including corrective action plans and collaborate with other department attorneys to support investigations into potential licensure violations, support compliance department audits of APP licensure compliance.
• Provide regulatory guidance to Vanderbilt Health’s clinically integrated network and Accountable Care Organizations supporting value base care initiatives.  Guidance includes advising on federal and state laws governing CINs and ACO models including clinical and financial network integration, legal structuring and governance of CINs and ACOs, care management and shared savings distribution models, assess contracts for compliance with fraud and abuse laws, FMV, and commercial reasonableness.
• Provide legal counsel and compliance oversight for Vanderbilt Health’s ambulance operations, including both ground and air ambulance services, including advising on Medicare and Medicaid ambulance coverage and reimbursement rules, proper billing practice for ambulance services and coordinating with outside counsel resources as needed to support the work, including ov