Contracts Review Attorney

Philadelphia, PA
Full Time
05-18-2021
Practice Areas: Managed Care Job #: 1190 Exp.: 7+ Years
Description:
Serve as Contracts Review Attorney to assist Chief Legal Officer/SVP, Legal Affairs with development, review, tracking and upkeep of contract management tasks for HPP. This position reports directly to the Chief Legal Officer and Division Head.

As a Contracts Review Attorney your daily duties may include…
  • 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.
  • Maintain contract management system to allow for collection of information related to NCQA, CMS, DHS, PID, DOH, internal business units, external or internal auditors, committees or work groups.
  • 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 and abuse laws and regulations, licensure and certification, healthcare information systems, and Medicare/Medicaid program requirements and reimbursement.
  • Serve as backup for hearings, senior level meetings, project lead for other attorneys in department.
  • Assist with other projects as needed.

Qualifications:
  • Bachelors degree; Juris Doctorate degree from ABA-approved Law School;
  • License to practice law in Pennsylvania.
  • 7 + years’ experience in managed care setting in contracting or legal department of major health insurer.
  • Knowledge of managed care, Medicaid and Medicare Skilled in healthcare contracting, drafting, negotiating, and interpretation.
  • Experience in medical-legal issues and laws, regulatory agencies, health insurance, and other national standards relative to the healthcare industry.
  • Management experience.
  • Must have quantitative analysis skills.
  • Proficient in Microsoft Outlook, Word and Excel and relational databases.
  • Exceptional presentation, oral and written communication, interpersonal, problem solving, multitasking and time management skills required Communicates clearly & professionally. Maintains composure in challenging situations. Collaborates with others. Asks for constructive feedback.
  • Promotes a culture of diversity, respect & accountability. Challenges other through productive discussion.
  • Pays attention to detail. Identifies & solves complex issues. Thinks “big picture” when assessing problems/opportunities. Develops innovative & creative solutions.
  • Follows all company policies & SOPs. Delegates, prioritizes and manages the work of others. Balances competing priorities, scheduling issues & deadlines. Delivers effective feedback. Manages cost, quality & expedience.
  • Motivates & empowers others. Acts in accordance with company vision, mission & values.
  • Takes accountability for own performance. Willing to take on additional assignments. Seeks out opportunities for leadership & development. Trains, coaches & mentors others. Champions change. Provide leadership, coaches, and /or mentoring to subordinate groups.

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