Senior Counsel Ofc Counsel

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Senior Counsel, Ofc Counsel

Duties: Provides legal services and advice with respect to general healthcare matters, healthcare contracts and transactions, regulatory compliance and payment and reimbursement issues including compliance with State and Federal laws regarding reimbursement for patient care services. Assists with the negotiation and drafting of contracts and rendering of legal advice related to third party payor relationships, transactions, and contracts, including, reimbursement agreements and contracts with commercial and governmental third party payors and managed care plans; Provides regulatory compliance advice, including but not limited to the Stark Law, Fraud and Abuse Laws, Medicare and Medicaid billing regulations (including CMS, Medicare Advantage, and New York State Medicaid). Knowledgeable about coverage determinations, coding and payment policies. Provides support to strategic payor contracting initiatives. Manages disputes, risks, and projects related to regulatory compliance, payor contracts and legal transactions; Provides legal assistance and guidance to the “340B” drug discount and related pharmaceutical programs operated by the University and its affiliates, including contract negotiations with 340B vendors and contract pharmacies. Provides guidance on legal issues arising relating to reimbursement for pharmaceuticals; Serves as legal liaison to and works in collaboration with the Medical Center’s billing compliance office. Assists with self- disclosures, audit responses and legal challenges to payor overpayment and adverse payment determinations. Coordinates as needed with regulatory agencies and responds to governmental regulatory initiatives; Delivers consistent superior quality, timely, ethical and efficient legal services for the University and its affiliates. Demonstrated ability to work collaboratively in a collegial environment; Serves on University and affiliate committees and reviews policies and provide advice to Medical Center leadership and Medical Center administrators. Conducts legal educational presentations for faculty and staff; Provides advice and guidance to leadership in one or more additional specialty health care topics, based on in depth knowledge sufficient to identify legal and regulatory issues; these areas may include but are not limited to: telemedicine, human subjects research, animal research, professional service agreements, medical director agreements, privacy and/or physician practice acquisitions; and Undertakes such other duties as may be assigned by the General Counsel of the University or of the Medical Center or as may be requested by senior administrators.

Additional Information

Job ID: 221949. Apply online.

Company info

University of Rochester Medical Center
University of Rochester
Rochester
New York
United States 14627
Website : http://www.urmc.rochester.edu