Payer Contracting, Policy and Regulatory Counsel

University of Vermont Medical Center; South Burlington (VT); On-site; USD 140,000 - 210,000; Full time

Job summary

University of Vermont Medical Center seeks a Payer Contracting, Policy & Regulatory Counsel to act as the lead legal and strategic advisor for payer contracting across the network. This role partners with finance, population health, revenue cycle, and leadership to advance financial performance and care transformation.

The position focuses on negotiating complex contracts, interpreting payer policies, and shaping reimbursement strategy within value-based care initiatives and regulatory

Qualifications

• JD from an accredited law school.
• Licensed and in good standing with the Vermont Bar or eligible for admission.
• Additional education or certification in Healthcare Administration / Compliance / Population Health.
• 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.
• Experience resolving payer disputes and reimbursement issues.
• Experience interpreting healthcare regulations and payer policy requirements.
• 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.

Responsibilities

• Serve as the lead legal, regulatory, and strategic advisor for payer contracting activities across the network.
• Bridge traditional managed care contracting with value-based care contracting and reimbursement strategy.
• Support payer negotiations, payment innovation, and enterprise-wide value-based transformation.
• Provide counsel on commercial payer agreements, Medicare Advantage, Medicaid, and APMs.
• Collaborate with Finance, Population Health, Revenue Cycle, Legal, and Executive leadership to align contracts with financial and transformation goals.
• Advise on regulatory developments impacting payer-provider relationships.

Skills

Payer negotiations

Healthcare law

Regulatory interpretation

Dispute resolution

Education

JD from an accredited law school

Vermont Bar license

Healthcare Administration / Compliance (preferred)

Job description

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