Managed Care Attorney/Lawyer

Job Description

The Managed Care Attorney will be responsible for managing, drafting, reviewing, and negotiating a variety of contracts, all while supporting compliance with federal and state regulations, primarily those related to Medicare, Medicaid, and managed care programs. This role calls for an experienced legal professional with a strong foundation in healthcare regulations, contracts, and managed care operations.

Key Responsibilities:

Draft, review, and negotiate a range of contracts, including vendor agreements, provider contracts, managed care contracts, service agreements, and partnership agreements.

Ensure compliance with federal and state regulations, focusing on Medicare, Medicaid, managed care policies, and broader healthcare laws.

Provide legal counsel on managed care operations and regulatory concerns, including issues involving Stark Law, Anti-Kickback Statute (AKS), HIPAA, and other relevant healthcare laws.

Collaborate with cross-functional teams in compliance, procurement, and healthcare departments to ensure contract terms align with organizational goals and legal requirements.

Stay informed about changes to Medicare and Medicaid programs, managed care practices, and other compliance updates to ensure contracts reflect evolving regulations.

Identify legal risks and provide solutions to mitigate financial and regulatory liabilities.

Maintain organized records of all contractual agreements, amendments, and regulatory files.

Required:

Juris Doctor (JD) from an accredited law school.

Active and in good standing membership in the bar association of [insert applicable state(s)].

Proven professional experience drafting, reviewing, and negotiating a wide range of contracts.

Strong knowledge and experience with Medicare and Medicaid regulations and health law compliance.

Preferred:

At least 3-5 years of legal experience in a managed care, compliance, or corporate law setting.

Familiarity with Stark Law, Anti-Kickback Statute (AKS), and HIPAA is a plus.

Strong written and verbal communication skills with the ability to present complex information to diverse audiences.