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Centers Plan for Healthy Living's goal is to create the ultimate healthcare experience that provides our members, their families, healthcare decision makers, and general caregivers with the guidance and plans they need for healthy living.

Job Summary

Reporting to the CEO, this position will be responsible for providing strategic and legal guidance on a range of business and regulatory matters, including but not limited to ; overseeing work product of outside counsel, performing health care regulatory due diligence, contract review and administration, including provider and vendor contracts/procurement, legal oversight of investigations - both internal and external, and providing legal transactional advice to Human Resources.

Primary Responsibilities

• Maintain comprehensive knowledge of health plan/managed care contracting, CMS and state Medicare regulations as applicable, including understanding of associated compliance
• Assist CPHL stakeholders in developing and implementing regulatory solutions that impact Medicare product lines and programs
• Analyze and distill complex legal issues into easily understandable content so key stakeholders across CPHL can move corporate goals and objectives forward
• Anticipate legal risk and provide legal advice to internal clients on best practice negotiation strategies and standard terms for agreements including contract interpretation, dispute resolution, and other legal risks
• Provide legal support responding to government and other third-party audits or investigations
• Review and approve negotiated agreements (provider agreements, vendor agreements, requests for proposals, statements of work, etc.)
• Serve as legal advisor to human resources department on employment matters and proceedings, develop legal strategies with workplace investigations, dispute resolution, evaluation of potential claims, settlement negotiations, internal fact development and other related activities
• Coordinate litigation-related activities with outside counsel
• Foster key regulatory relationships
  

Education And Experience

Education

• Juris Doctor from an accredited institution
  

Required

Type of Experience

• 5+ years related legal experience
• Excellent analytical, organization, oral and written communication skills
  

Required

Certifications/Licensure:

• License to Practice La w
• Active NYS Bar Admission
  

Knowledge And Skills

• Strong influencing and partnership skills
• Ability to apply business and technical expertise to identify potential issues and help solve problems
• Detail oriented
• Experienced in contract review
• Strong leadership competencies
  

SCOPE INFORMATION

# Direct Reports: N/A

Physical Requirements

The physical requirements described here are representative of those that must be met by an employee to successfully perform the essential functions of this job. Reasonable accommodations may be made to enable individuals with disabilities to perform the essential functions.

The above statements are intended to describe the general nature and level of work performed by individuals assigned to the job classification.They should not be construed as an exhaustive list of all responsibilities, duties and skills required.

Centers Plan For Healthy Living is committed to leveraging the diverse backgrounds, perspectives and experiences of our workforce to create opportunities for our employees and our business. We are an equal opportunity employer and all qualified applicants will receive consideration for employment without regard to race, color, religion, sex, national origin, disability, protected veteran status or any other characteristic protected by law and will not be denied employment.

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