Payer Contracting, Policy and Regulatory Counsel

Elizabethtown Community Hospital; Burlington (VT); Sur place; USD 180 000 - 240 000; Plein temps

Résumé du poste

The University of Vermont Health Network seeks a Payer Contracting, Policy & Regulatory Counsel to serve as lead legal, regulatory, and strategic adviser for payer contracting across the network. This role bridges traditional managed care contracting with value-based care, payer policy analysis, and contract performance management.

Reporting to the Vice President of Payer Strategy, Contracting, this position partners with finance, population health, operations, revenue cycle, and executive

Qualifications

• Must hold a JD and be in good standing or eligible for admission to the Vermont Bar.
• Experience negotiating and reviewing complex healthcare contracts is required.
• Ability to interpret healthcare regulations and payer policy requirements.
• Strong communication with cross-functional teams including finance and population health.

Responsabilités

• Provide legal, regulatory, and strategic counsel for payer contracting activities.
• Support payer negotiations, reimbursement strategy, payment innovation, and value-based care transformations.
• Advise on Medicare Advantage, Medicaid managed care, and other payer agreements.
• Ensure contracts align with organizational financial performance and care transformation goals.
• Collaborate with executive leadership and other departments to manage disputes and regulatory compliance.

Connaissances

Payer contracting

Regulatory analysis

Contract negotiation

Healthcare law

Strategic business partnering

Formation

Juris Doctor (JD) from an accredited law school

Licensed to practice law in Vermont or eligible for admission

Description du poste

The Payer Contracting, Policy & Regulatory Counsel serves as the lead legal, regulatory, and strategic advisor for payer contracting activities across the University of Vermont Health Network. As a key member of the integrated Payer Strategy and Contracting team, this role bridges traditional managed care contracting, value-based care contracting, payer policy analysis, regulatory interpretation, dispute resolution, and contract performance management.

Unlike a traditional healthcare attorney focused solely on legal review, this position functions as a strategic business partner supporting payer negotiations, reimbursement strategy, payment innovation, and enterprise-wide value-based transformation. The role works closely with contracting, finance, population health, operations, revenue cycle, and executive leadership to ensure payer agreements advance organizational objectives related to financial performance, care transformation, quality outcomes, and population health management.

The position provides legal and strategic counsel regarding commercial payer agreements, Medicare Advantage contracts, Medicaid managed care arrangements, accountable care organization agreements, alternative payment models, value-based reimbursement programs, payer policies, regulatory compliance, contract disputes, and payment integrity matters. The role serves as the organization’s subject matter expert on payer contract interpretation, reimbursement policy, and regulatory developments impacting payer-provider relationships.

Reports to

Vice President, Payer Strategy, Contracting

Key relationships

High Value Care leadership / CFOs / Population Health / Revenue Cycle /Legal, Compliance /Finance / Clinical Leaders / payer representatives / outside counsel

EDUCATION

Required

• Juris Doctor (JD) from an accredited law school.
• Licensed and in good standing with the Vermont Bar or eligible for admission.

Preferred

Additional education or certification in: Healthcare Administration / Healthcare Finance / Compliance / Population Health / Value-Based Care

EXPERIENCE

Required

• Minimum of 7 years of progressively responsible experience in healthcare law, managed care contracting, or payer strategy.
• Significant experience negotiating and reviewing complex healthcare contracts.
• Demonstrated experience resolving payer disputes and reimbursement issues.
• Experience interpreting healthcare regulations and payer policy requirements.

Preferred

Experience within an integrated delivery network, academic medical center, health system, or payer organization

Experience with:

• Commercial payer negotiations
• Medicare Advantage contracting
• Medicaid managed care programs
• Value-based care arrangements
• Accountable Care Organizations
• Population health initiatives
• Specialty pharmacy reimbursement