Associate CLO Managed Care

1103 Team Member Services; United States; Presencial; USD 226.000 - 451.000; Jornada completa

Ventajas ofrecidas por este puesto de trabajo

Medical Insurance

Dental Insurance

Vision Insurance

Life Insurance

Disability Insurance

403-B Retirement Plan

Paid Parental Leave (4 weeks)

Career Development

Whole Person Well-being Resources

Mental Health Resources and Support

Pet Benefits

Descripción de la vacante

AdventHealth is seeking a senior Corporate Legal professional to lead the newly established Dispute Resolution function, focusing on payer disputes and reimbursement strategies. You will collaborate with Managed Care, Revenue Cycle, and Analytics to align legal strategy with operational execution.

The role requires extensive in-house and/or law firm experience, strong regulatory knowledge, and proven leadership to guide outside counsel and internal teams across a national footprint.

Formación

• Extensive knowledge of legal principles in related areas of law.

Responsabilidades

• Assist business leaders and departments in developing and maintaining legally compliant policies and practices.
• Develop and lead a team of attorneys and support staff within their specific area of expertise.
• Participate in the overall development of the legal services department, internally and externally.
• Consult across business and legal operations, provide mentorship and contribute specialized knowledge.
• Provide the executive management team of AdventHealth with an understanding of legal parameters and motivating compliance with legal requirements.
• Maintain communication with other attorneys and/or senior leadership regarding legal developments and requirements for compliance.
• Draft memoranda and/or other documents responding to governmental, external or internal charges, audits and investigations, legal demands, and inquiries from clients.
• Provide documentation and communication regarding specialized organizational processes.
• Evaluate organizational needs, determine suitable technical or other solutions, and ensure defined requirements are met.
• Improve organizational efficiency by applying expert and authoritative knowledge to resolve complex challenges.
• Provide business leaders with expert guidance on problem-solving, decision-making processes, and risk-related decisions pertaining to business operational decisions, projects or transactions to optimally integrate ideas and solutions.
• Manage outside counsel’s support for company initiatives and handling of litigation or complex projects or transactions (as applicable), along with advanced ability to recommend and guide outside counsel with thoughtful and authoritative decisions.
• Performs other duties as assigned.

Conocimientos

Executive leadership

Analytical thinking

Mentorship

Communication

Detail oriented

Time management

Team collaboration

Regulatory awareness

Educación

Law Doctorate (JD or equivalent)

Herramientas

Lexis

Microsoft Office

Online legal research

Descripción del empleo

Our promise to you: Joining AdventHealth is about being part of something bigger. It’s about belonging to a community that believes in the wholeness of each person, and serves to uplift others in body, mind and spirit. AdventHealth is a place where you can thrive professionally, and grow spiritually, by Extending the Healing Ministry of Christ. Where you will be valued for who you are and the unique experiences you bring to our purpose-minded team. All while understanding that together we are even better. All the benefits and perks you need for you and your family: Benefits from Day One: Medical, Dental, Vision Insurance, Life Insurance, Disability Insurance Paid Time Off from Day One 403-B Retirement Plan 4 Weeks 100% Paid Parental Leave Career Development Whole Person Well-being Resources Mental Health Resources and Support Pet Benefits

Schedule

Full time Shift: Day (United States of America) Address: 902 INSPIRATION AVE City: ALTAMONTE SPRINGS State: Florida Postal Code: 32714

Job Description

• Assist business leaders and departments in developing and maintaining legally compliant policies and practices
• Develop and lead a team of attorneys and support staff within their specific area of expertise
• Participate in the overall development of the legal services department, internally and externally
• Consult across business and legal operations, provide mentorship and contribute specialized knowledge
• Provide the executive management team of Adventist Health System with an understanding of legal parameters and motivating compliance with legal requirements
• Maintain communication with other attorneys and/or senior leadership regarding legal developments and requirements for compliance
• Adhere to Department File System Policy(ies), Directory Policy(ies), Service Log Policy(ies), and Best Practices Policy(ies)
• Draft memoranda and/or other documents responding to governmental, external or internal charges, audits and investigations, legal demands, and inquiries from clients
• Provide documentation and communication regarding specialized organizational processes
• Evaluate organizational needs, determine suitable technical or other solutions, and ensure defined requirements are met
• Improve organizational efficiency by applying expert and authoritative knowledge to resolve complex challenges
• Provide business leaders with expert guidance on problem-solving, decision-making processes, and risk-related decisions pertaining to business operational decisions, projects or transactions to optimally integrate ideas and solutions
• Manage outside counsel’s support for company initiatives and handling of litigation or complex projects or transactions (as applicable), along with advanced ability to recommend and guide outside counsel with thoughtful and authoritative decisions
• Performs other duties as assigned

Position Focus

Corporate Legal is embarking on a new area of focus and is developing a legal team to drive the newly established Dispute Resolution function, focused on payment-related matters in conjunction with Managed Care and Revenue Cycle. This work will include leading and executing resolution strategies as well as managing outside counsel. This position will have a dual reporting relationship to the Chief Legal Officer and the leader of the new Dispute Resolution function to ensure alignment across legal strategy and operational execution. Given the increasing complexity of payer disputes and reimbursement challenges, this role requires an attorney with a strong understanding of healthcare regulatory frameworks, insurance company strategies, and payment-related regulations. This expertise will enable the organization to more effectively leverage applicable regulatory platforms, strengthen our position in payment disputes, and support enterprise efforts to optimize reimbursement outcomes. This position will enhance collaboration between Legal, Managed Care, Revenue Cycle, Payer Analytics Center of Excellence, and the Dispute Resolution function while providing dedicated legal expertise to address emerging payment and regulatory issues.

Knowledge, Skills, and Abilities

• Extensive knowledge and expertise of legal principles in related areas of law [Required]
• Proficiency in legal research, including Lexis and other research tools [Required]
• Comprehensive knowledge of legal publications and the ability to use them efficiently including computer assisted research by using on-line services [Required]
• Exceptional ability to reason logically and analytically [Required]
• Expert ability to grasp, comprehend and analyze complex legal issues and complicated factual details [Required]
• Exceptional ability to work collaboratively and effectively with others as well as work independently, without close supervision [Required]
• Familiarity with Microsoft’s office suite, email applications, and other software resources [Required]
• Authoritative ability to provide sound practical legal advice, in simple and logical terms, in response to client inquiries and proactively as needed [Required]
• Ability to develop strong relationships with leadership and department colleagues for effective teamwork [Required]
• Excellent recordkeeping, as well as written and verbal communications skills [Required]
• Excellent analytical, problem solving, and communication skills with ability to translate complex concepts for non-experts [Required]
• Detail-oriented and highly motivated [Required]
• Excellent time management and organizational skills [Required]
• Able to work under high pressure and meet time sensitive deadlines [Required]
• Exceptional leadership and mentorship abilities [Required]
• Collaborative skills related to working with a team [Preferred]

Education

• Doctorate [Required]
• Field of Study: in Law

Work Experience

• 10+ years of relevant law firm experience in the subject law [Required]
• 10+ years relevant law practice experience for position [Required]
• Proven experience as a subject matter expert [Required]
• 5+ years of in-house experience [Preferred]
• Experience leading legal team in support of operations [Preferred]

Licenses and Certifications

• Member of State Bar Association [Required] OR Authorized House Counsel (AHC) [Required]

Physical Requirements

Physical Requirements - Pay Range: $225,721.60 - $451,464.00

Background Screening Requirement (Florida Law)

Certain positions are subject to Florida Level 2 background screening, including fingerprinting, as required by state law. Applicants may review general information about Florida’s background screening requirements at the Florida Care Provider Background Screening Clearinghouse: https://info.flclearinghouse.com/

This facility is an equal opportunity employer and complies with federal, state and local anti-discrimination laws, regulations and ordinances.

Every day, our fellow team members show up to work, unified by one shared mission: Extending the Healing Ministry of Jesus Christ. As a faith-based health care organization, our story is one of hope as we strive to heal and restore the body, mind and spirit. Though our facilities are spread across the country, this unwavering belief binds us together. Across every office, exam and patient room, we’re committed to providing individualized, holistic care. This is our Christian mission, and it inspires us to help make communities healthier and happier.