The TES Senior Regulatory Counsel provides legal advice and support to the TES business unit regarding complex federal and state regulatory laws, regulations, and payer-client program requirements governing third party billing (e.g., identification and return of overpayments, credit balances, balance billing, provider and biller enrollment), pharmacy benefit, accountable care, consultant and print services. The TES Senior Regulatory Counsel creates and provides guidance and training on applicable laws, regulations, and federal health care program requirements both within the Legal & Compliance organization as well as other parts of the organization. Additionally, the TES Senior Regulatory Counsel provides legal guidance pertaining to responses to government investigations and requests for information, voluntary refunds to governmental payers, internal investigations related to the above-referenced key areas of focus, and works collaboratively with the TES Chief Compliance Officer on investigations, risk assessments, risk mitigation initiatives, and applicable TES policies and procedures.
Candidates for this position will be based in Atlanta or Nashville.
- Reports to: Managing Senior Counsel
- Direct Reports: Regulatory Counsel
- Size and complexity
- Experience managing complex regulatory legal issues to a broad group of stakeholders and constituents
- Ability to navigate and work across multiple stakeholders and constituents to develop, communicate, and support a company's short-term and long-term business objectives when balanced against regulatory laws, regulations and health care program requirements
- Functional and industry experience
- Exceptional legal training and experience, including regularly advising clients on complex regulatory issues; a demonstrated track record of offering proactive and practical advice to various levels of management, including other attorneys and executives
- Breath of Experience
- Proven experience and expertise in working in a large and complex health system, law firm or in a health care focused government agency, and excelling in organizations which are transforming or constantly changing or growing.
10 years of experience providing regulatory legal counsel to clients at a health system, law firm, or health care focused government agency.
- In-depth knowledge of regulatory laws, regulations and federal health care program requirements
- Expertise at drafting legal memos and related advice documents, and policies and training documents
- Comprehensive understanding of business/joint ventures structures, regulatory matters, and risk management
- Excellent interpersonal skills with an ability to provide sound, clear legal advice to clients
- Aptitude to work well with larger team on seeking efficiencies for legal support
- Ability to manage simultaneous projects in an efficient and timely manner
- Outstanding verbal and written communication skills and advances knowledge of the law
- Strategic thinking: capable of providing clear, balanced advice/counsel on a broad range of regulatory laws and regulations
- Driving results: results-oriented style with a high degree of analytical ability and proven problem solving skills
- Leading change: ability to thrive and quickly adapt to change, leading others through change in a dynamic, fast-paced industry and work environment
- Collaborating and influencing: effectively builds strong relationships and partnerships within and outside of the company; ability to effectively navigate within a matrixed corporate structure
- Ability to communicate effectively at all levels of the organization with an open, honest and direct communication style that establishes an empathetic and effective relationship with front-line, mid-level, and executive personnel
Juris Doctor Degree from an ABA accredited law school with excellent academic credentials; admission to practice in good standing as a member of a jurisdiction is required
Join our team today where we are creating a better coordinated, increasingly collaborative, and more efficient healthcare system!