Senior Corporate Counsel, Managed Care & Reimbursement

El Camino Health; Mountain View (CA); On-site; USD 143,000 - 214,000; Full time

Job summary

El Camino Health in Mountain View, CA seeks a Corporate Counsel - Managed Care to provide practical legal advice on payor contracting, reimbursement, and physician network matters. Reports to the Associate Chief Legal Officer and partners with Finance, Revenue Cycle, and clinical leadership.

The ideal candidate has seven+ years of healthcare law experience, a JD from an ABA-accredited school, and deep knowledge of Knox-Keene Act, DMHC, CMS, and payer disputes.

Qualifications

• Juris Doctor from ABA-accredited law school.
• 7+ years of healthcare law experience, especially in managed care and reimbursement.
• Strong knowledge of payer contracting, provider networks, and regulatory frameworks.
• Experience advising on disputes involving claims denials, underpayments, and appeals.

Responsibilities

• Serve as primary legal advisor to Finance, Payor Relations & Managed Care, Revenue Cycle, and Physician Network leadership on managed care matters.
• Review, draft, negotiate, and interpret managed care agreements (PPO, HMO, Medicare Advantage, etc.).
• Advise on payor reimbursement disputes, audits, and denials, and assist with related appeals.
• Provide guidance on provider network participation, product participation disputes, and in-network vs out-of-network issues.
• Coordinate with outside counsel on litigation, regulatory matters, and significant payor disputes.
• Monitor developments in healthcare reimbursement and regulatory law and translate into actionable guidance for leaders.

Skills

Healthcare law

Managed care

Contract negotiations

Regulatory compliance

Legal advisory

Cross-functional collaboration

Education

Juris Doctor (ABA-accredited)

Job description

El Camino Health in Mountain View, CA seeks a Corporate Counsel - Managed Care to provide practical legal advice on payor contracting, reimbursement, and physician network matters. Reports to the Associate Chief Legal Officer and partners with Finance, Revenue Cycle, and clinical leadership.

The ideal candidate has seven+ years of healthcare law experience, a JD from an ABA-accredited school, and deep knowledge of Knox-Keene Act, DMHC, CMS, and payer disputes.