Optima Health, an affiliate of Sentara Healthcare, seeks a health plan/insurance attorney with at least five years experience practicing in the health care or insurance department of a law firm and/or in-house with a health plan.

The attorney may be required to lead or participate in governmental and legislative initiatives on behalf of the organization and in collaboration with the organization’s governmental affairs staff in support of subsidiary organizations. The attorney will work with executives to identify proactively, and evaluate the impact to the organization of, changes in laws or regulations, and to guide the organization’s actions in support of such legal or statutory changes and in furtherance of the organization’s objectives. Further, the attorney will be expected to contribute in other areas of operations of Optima’s parent company, Sentara Healthcare, and its other operating subsidiaries. Therefore, the ideal candidate will also have background and interest in general health care areas such as: anti-kickback and Stark compliance; medical staff relations, bylaws, rules and regulations; peer review matters and proceedings; provider-based operations; rules and regulations governing tax-exempt status; labor and employment issues; accreditation matters; and government program reimbursement. The ideal candidate will be willing and able to accept a high degree of independence yet still work closely with the Sentara Healthcare legal department. Optima Health is headquartered in Virginia Beach, Virginia, the principal location for this position, and Sentara Healthcare is headquartered in adjacent Norfolk, Virginia. Sentara Healthcare is the largest integrated health care provider in southeastern Virginia and northeastern North Carolina, serving more than 2 million residents. Sentara also serves more than 500,000 residents in the Blue Ridge area and about 375,000 in Northern Virginia. With 23,000+ members of the team, Sentara operates 10 acute care hospitals; operates more than 100 sites of care; Sentara Medical Group consists of about 380 primary care and multi-specialty physicians. Sentara ranked first in Modern Healthcare’s 2011 list of top integrated healthcare networks and is the only healthcare system in the country to be among the nation's top 10 for all 14 years of the survey. Learn more about us at www.optimahealth.com and www.sentara.com.

To join our legal department, go to www.optimahealth.com/jobs to complete the online application for immediate consideration.

The individual will serve as primary in-house counsel for Optima Health, and will address both complex and routine managed care and insurance operations and administrative issues as well as regulatory and compliance matters. As such, experience in the following areas is of particular interest:

• Negotiating and preparing agreements for new and traditional product offerings. • Negotiating and preparing provider/hospital network participation and related agreements. • Assisting in risk management and insurance activities. • Reviewing and analyzing policy language and ensuring that it complies with agreed upon benefits, that certificates of insurance are accurate and that internal teams are administering benefits as required by contractual policy terms. • Analyzing and advising on all applicable federal and state statutes, laws, and regulations, including Health Care Reform, HIPAA, etc. • Supporting operations, sales, IT and executive legal needs and requirements. • Coordinating and supervising any litigation with outside counsel. • Minimum of five years experience practicing in the health care or insurance department of a law firm and/or in-house with a health plan. • Juris Doctorate required. Must be licensed to practice law in at least one state. If licensed in a state other than Virginia, must have Virginia Corporate Counsel license.