Division Counsel â Reimbursement and Managed Care
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. It is a place where your diversity â of culture, thinking, learning and leading â 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. VUMCâs mission is to advance health and wellness through preeminent programs in patient care, education, and research.
VUMC is seeking an attorney with experience advising and providing legal support for manage care and other revenue cycle department, including expertise in review, drafting and advising on payor contracts, managed care contract compliance and maintenance of policies related to payor contracts, Medicare and Medicaid provider enrollment and conditions of participation, accounts receivable management, collections vendor management, and federal and state laws, regulations and guidance documents related to governmental and private insurance, managed care and healthcare reimbursement. This position will carry the title of Division Counsel and will work within the Office of Legal Affairs, reporting to a Managing Counsel and the VUMC General Counsel. This Division Counsel will work closely with the Senior Vice President for Revenue Cycle and Payer Strategy and other stakeholders, as necessary to support both revenue cycle and institutional goals.
Candidates must possess a minimum of seven (7) yearsâ experience of directly relevant experience in frequent or primary engagement with a health systemâs managed care department and Finance/Revenue Cycle office. The ideal candidate will have experience with litigation, as well as a working knowledge of the Tennessee laws and regulations related to managed care and, in particular, TennCare. Preference will be given to candidates with experience advising academic medical centers. Experience with the Fair Debt Collection Practices Act (FDCPA) and other legal requirements related to patient accounts, the Payment Care Industry Data Security Standard, the Telephone Consumer Protection Act, and payor claims reviews and audits is also desirable. The successful candidate will be a good negotiator with excellent oral and written communication skills and will have the ability to work independently within a dynamic and fast paced environment. Excellent client management skills and the ability to prioritize competing demands will be necessary.
Draft, negotiate, review and advise on payor contracts and vendor contracts related to revenue cycle functions;
Provide risk assessments and legal advice regarding compliance with health care and corporate laws and regulations, including federal and state fraud, waste and abuse laws and state and federal laws and regulations related insurance, managed care and collections;
Monitor changes in relevant regulatory areas and provide education on those changes to business and operational personnel and compliance and legal affairs teams;
Advise on insurance, managed care, Medicare and Medicaid (TennCare) contracting and payment issues, enrollment requirements, and conditions of participation;
Provide guidance and assistance to other colleagues in the Office of Legal Affairs in a highly collaborative and team-oriented fashion.
JD degree from an ABA accredited law school.
Must have at least seven (7) years of directly applicable experience.
Employment contingent upon State of Tennessee licensure or registration and receipt of In-House Counsel Practice Certificate. The successful candidate must apply for and become licensed in the State of Tennessee within 12 months of employment or, if earlier, the date required under applicable rules of the Tennessee Supreme Court.
Vanderbilt University Medical Center is a comprehensive health care facility dedicated to patient care, research, and biomedical education. Our reputation for excellence in these areas has made us a major center for patient referrals from throughout the Mid-South. Each year, people throughout Tennessee and the Southeast choose Vanderbilt University Medical Center for their health care because of our leadership in medical science and our dedication to treating patients with dignity and compassion.The mission of Vanderbilt University Medical Center is to advance health and wellness through preeminent programs in patient care, education, and research.