Senior Corporate Counsel, Managed Care & Reimbursement

El Camino Hospital; Mountain View (CA); Sur place; USD 143 000 - 215 000; Plein temps

Résumé du poste

El Camino Health in Mountain View is seeking a Corporate Counsel - Managed Care to provide practical, business‑oriented legal advice on payor contracting, reimbursement, and physician network matters. You will advise Finance, Payor Relations & Managed Care, Revenue Cycle, and leadership on complex payor disputes and contract negotiations.

The ideal candidate has seven+ years of healthcare law experience, a California JD, and strong knowledge of Knox‑Keene Act, DMHC, CDI and Medicare rules.

Qualifications

• Seven+ years of healthcare law experience including managed care, reimbursement, payor contracting, or regulatory matters.
• Strong knowledge of managed care contracting principles, reimbursement methodologies, and regulatory frameworks.
• Experience advising on disputes involving claims denials, underpayments, and payor enforcement activities.
• Familiarity with California healthcare regulations, including the Knox-Keene Act and DMHC/CDI.
• Experience supporting IPAs, CINs, physician organizations, or similar networks.
• Excellent executive-level verbal and written communication skills.

Responsabilités

• Serve as the primary legal advisor to Finance, Payor Relations & Managed Care, Revenue Cycle, and leadership on managed care and reimbursement matters.
• Review, draft, negotiate, and interpret managed care agreements (PPO, HMO, Medicare Advantage, etc.).
• Advise on payor reimbursement disputes, denials, underpayments, audits, and related appeals processes.
• Collaborate with operational teams to resolve systemic payor issues affecting reimbursement and network participation.
• Draft and negotiate correspondence, notices of breach, settlement agreements, and other communications.
• Support regulatory compliance, audits, and regulatory inquiries in the managed care space.
• Manage outside counsel for litigation, arbitration, and significant payor disputes.
• Translate regulatory changes into actionable guidance for operational leaders.

Connaissances

Legal experience

Executive communication

Contract negotiations

Healthcare regulatory

Cross-functional collaboration

Risk management

Independent work

Analytical thinking

Formation

Juris Doctor (ABA-accredited)

Description du poste

El Camino Health in Mountain View is seeking a Corporate Counsel - Managed Care to provide practical, business‑oriented legal advice on payor contracting, reimbursement, and physician network matters. You will advise Finance, Payor Relations & Managed Care, Revenue Cycle, and leadership on complex payor disputes and contract negotiations.

The ideal candidate has seven+ years of healthcare law experience, a California JD, and strong knowledge of Knox‑Keene Act, DMHC, CDI and Medicare rules.