Medica Health Plans

Associate General Counsel III, Provider Contracting

Medica Health Plans$130K — $195K *
Healthcare
5 - 7 years of experience
Job Overview by Ladders

Qualifications

  • J.D. degree from an ABA-accredited law school with a current legal practice license in the U.S.
  • 5+ years of legal experience post-J.D.
  • Proficient in contract drafting and negotiations.

Responsibilities

  • Draft and amend provider contract templates, including value-based payment provisions.
  • Serve as the primary contact for Network contract managers regarding template inquiries and counterproposals.
  • Engage in direct negotiations with provider legal counsel.
  • Provide legal support for investigations into provider quality of care and compliance complaints.
  • Advise on dispute resolution related to claims payment with providers.
  • Conduct research on state and federal laws and regulatory guidance.

Benefits

  • Generous medical, dental, and vision coverage.
  • Paid time off (PTO) and holidays.
  • Paid volunteer time off.
  • 401K contributions.
  • Caregiver services and additional employee support benefits.
Full Job Description
Medica is seeking to hire an Associate General Counsel III to join our Legal Department and support our Provider Network contracting team. Our General Counsel provides legal advice and services on issues concerning the rights, obligations, and privileges of the organization. This role will protect the organization's rights in contract negotiations, settlements and dispute resolution, and provide a full range of legal advice and services and may specialize in one of more areas of law: insurance, health, government programs, commercial, contracts, benefit, anti-trust investigations, tax law, regulatory and compliance. Performs other duties as assigned.

Key Accountabilities

  • Draft provider contract templates, amendments, including value-based payment provisions
  • Be the first point of contact for Network contract managers with provider contract template questions and requests for assistance with counterproposal language
  • Negotiate directly with provider legal counsel
  • Give legal support for provider quality of care and FWA investigations and regulatory complaint responses involving providers
  • Advise and engage in dispute resolution on claims payment issues with providers
  • Research State/Federal laws, regulations, and sub-regulatory guidance


Required Qualifications

  • J.D. degree from an ABA-accredited law school and a current license to practice law in at least one United States jurisdiction
  • 5+ years of work experience beyond degree
  • Contract experience and negotiation experience


Required Certifications/Licensure

  • J.D. degree from an ABA-accredited law school and a current license to practice law in at least one United States jurisdiction


Preferred Qualifications

  • Experience within the healthcare, health insurance or insurance industry. Experience from heavily regulated industries such as banking, financial services, etc. will also be considered.
  • Knowledge of ERISA and HIPAA preferred
  • Experience building and maintaining a rapport with internal clients and external business partners


Skills and Abilities

  • Strong Project Management skills - able to organize, document, manage and improve complex department processes, workflows, and shared resources
  • Excellent writing, editing, and proofreading skills and experience working with contracts, templates or other legal documentation to include review, interpretation, editing, creation.
  • Well-developed analytical and problem-solving skills
  • Able to independently analyze complex business issues and provide solution recommendations based on an accurate interpretation of the law
  • Situationally aware, able to apply consistent judgment to seek decision support from their manager and or the legal team
  • Will be required to leverage the expertise of Medica department leads, this position needs to build strong working rapport with internal and external teams
  • Maintains focus on time sensitive deliverables and under sometimes stressful circumstances and rapid changes in demand, can appropriately re-prioritize tasks and projects


This position is an Office role, which requires an employee to work onsite, on average, 3 days per week. We are open to candidates located near one of the following office locations: Minneapolis, MN, Madison, WI, Omaha, NE, St. Louis, MO.

The full salary grade for this position is $130,300 - $223,400. While the full salary grade is provided, the typical hiring salary range for this role is expected to be between $130,300 - $195,510. Annual salary range placement will depend on a variety of factors including, but not limited to, education, work experience, applicable certifications and/or licensure, the position's scope and responsibility, internal pay equity and external market salary data. In addition to base compensation, this position may be eligible for incentive plan compensation in addition to base salary. Medica offers a generous total rewards package that includes competitive medical, dental, vision, PTO, Holidays, paid volunteer time off, 401K contributions, caregiver services and many other benefits to support our employees.

The compensation and benefits information is provided as of the date of this posting. Medica's compensation and benefits are subject to change at any time, with or without notice, subject to applicable law.

Eligibility to work in the US: Medica does not offer work visa sponsorship for this role. All candidates must be legally authorized to work in the United States at the time of application. Employment is contingent on verification of identity and eligibility to work in the United States.

About Medica Health Plans

Medica Health Plans is a non-profit health insurance company based in Minnesota. It was founded in 1975 and provides health insurance to individuals, families, and employers in Minnesota, North Dakota, South Dakota, and Wisconsin. Medica offers a variety of health plans, including HMO, POS, PPO, and Medicare Advantage plans. The company also offers dental, vision, and pharmacy benefits. Medica has received high ratings for customer satisfaction and quality of care. The company is committed to improving the health of its members and the communities it serves.
Learn more about Medica Health Plans
Size
1,700 employees
Industry
Founded
1975

Similar Jobs

More Jobs at Medica Health Plans

More Healthcare Jobs

Find similar Associate General Counsel III, Provider Contracting jobs: