ACC is committed to compliance with all applicable equal employment laws. ACC In-house Jobline listings may not explicitly or implicitly discriminate on the basis of any prohibited factor.
Listings on the ACC In-house Jobline are for in-house attorney positions only. While we do not accept non-attorney corporate job listings, if you are hiring a corporate legal operations professional, contact LawDepartmentOps@ACC.com. By posting a job on the ACC In-house Jobline or using the service as a job seeker, you are agreeing to comply with our Terms and Conditions, including those relating to discrimination. The system administrator may delete postings, which do not comply. Employer postings removed by ACC are not subject to refund.
We are very interested in your thoughts as we continue to develop the ACC In-House Jobline to better serve your needs. If you have questions about ACC In-house Jobline, please call our helpdesk at: 1-888-491-8833 Ext. 1125 (Extension Required).
Manage, coordinate and implement a broad range of projects and programs in direct support of Legal Affairs. Serve as Assistant Counsel in Legal Affairs Department, reporting to General Counsel/Vice President, Legal Affairs. Charged with development, review, tracking and upkeep of contract management tasks for HPP; managing the functions of Subrogation and managing the subrogation staff; as well as handling cases when another party is legally liable for the claims of Plan members; creating, reviewing, monitoring and submitting all regulatory required reports for subrogation and exercising independent judgment and decision making on subrogation cases with guidance provided to staff for handling cases; providing backup support for hearings, administrative law matters and other legal proceedings as necessary; managing litigation internally and in coordination with external counsel; and assisting with research and guidance for corporate legal needs, projects and/or reports as requested by General Counsel.
Able to work in a constant state of alertness and safe manner.
Perform legal research, investigate matters, provide advice and memoranda/opinions, as assigned by General Counsel.
Effectively and efficiently manage contract drafting, editing and negotiations & processes for tracking same in accordance with Company policies and procedures.
Responsible to update all health plan contracts when necessary due to information changes, requirements based on regulations, standards, and/or Company protocol.
Ensuring compliance with Company policies and procedures and regulatory requirements for contract processing, management, negotiations and maintenance/repository of contracts.
Establish and maintain timely and accurate communication channels with other business units to ensure contract process is effective. Ability to implement standards and requirements of NCQA, CMS, DHS, PID, DOH, internal business units, external or internal auditors, committees or workgroups which impact contracts, legal guidance, research
Conduct initial and periodic review of contracts relative to financial arrangements, service arrangements, reasonableness, term limits, and other applicable topics
Ability to handle multiple complex legal projects in a fast-paced environment
Demonstrated experience with health care contracting, provider and payor relationships, and health care regulatory structures including health care fraud, waste and abuse laws and regulations, licensure and certification, healthcare information systems, and Medicare/Medicaid program requirements and reimbursement
Assist in developing goals and objectives for the Subrogation staff
Handle the issues and processes related to subrogation, reporting, third party liability and attorney lien requests
Prepare drafts of pleadings and correspondence for internal and external counsel; develop strategy for external counsel and assist external counsel in preparation for litigation; negotiate with outside parties on potential-litigation matters; gather responses to information requests relative to lawsuits, liens, etc.; attend arbitrations, hearings and other court appearances for internal litigation matters and coordinate with external counsel when applicable. Assist with other projects as directed by the General Counsel. Supervisory Responsibility: This position has overall supervisory responsibility for subrogation staff and/or others as directed by the General Counsel.
Required Education and Experience:
Education: Required: Undergraduate degree; Juris Doctor Degree from accredited Law School; 5+ years’ experience in managed care or health insurer in-house setting or in contracting or legal/compliance department
Strong negotiations and conflict resolution skills.
Experience in healthcare contracting, drafting/negotiating and interpreting contracts.
Knowledge of managed care, Medicaid and Medicare; and, healthcare compliance.
Working knowledge of subrogation, other party liability, liens.
Pleasant, courteous, professional, team player.
Excellent organizational, interpersonal, time management and communications skills.
Superior interpersonal skills, oral and written communication skills and analytical ability.
Preferred: Working experience with PC based applications such as Excel, Access, and Word preferred.
Process and project management ability.
In-house healthcare experience.
Other Duties Please note this job description is not designed to cover or contain a comprehensive listing of activities, duties or responsibilities that are required of the employee for their job. Duties, responsibilities, and activities may change at any time with or without notice.
Internal Number: 872
About Health Partners Plans
Health Partners Plans is an award-winning, not-for-profit health maintenance organization serving more than 280,000 members in Bucks, Chester, Delaware, Lancaster, Lehigh, Montgomery, Northampton, and Philadelphia counties.
We offer Medicaid, Medicare and Children’s Health Insurance Program (CHIP) plans that include special benefits to improve the health and wellness of our members. We’re also committed to boosting the health of our community through outreach, education and events.
We continually develop new ways to encourage better health outcomes and have received national recognition for our innovations in managed care.