National Provider Corporate Counsel at Wellcare

Remote
Wellcare

National Provider Corporate Counsel

Requisition Number: 1907364

Department: Legal

Reports to: Managing Attorney, National Provider

Location: Tampa or Remote

Description

National practice group leader forming and leading a Legal team working on all aspects of legal support for WellCare’s health care provider network issues, including sophisticated contracting, strategic partnerships/ACOs, payment systems and quality, credentialing, medical economics, terminations and regulatory and reporting regimes applicable to provider relationships (e.g., prompt pay, anti-kickback, etc).

Essential Functions:

  • Supporting WellCare’s regional/state lawyers and business clients across the U.S. on all aspects of provider contracting, including ensuring compliance with government program rules applicable to provider relationships
  • Provider Risk Arrangements
  • Providing legal counsel on federal and state regulatory regimes applicable to provider relationships
  • Supporting strategic WellCare-provider partnerships and alliances (e.g., ACOs)
  • Providing legal advice around economic initiatives impacting providers
  • Monitoring and reporting on relevant developments and trends
  • Assisting where needed on provider disputes and litigation, including payments, credentialing and terminations
  • Facilitating a cross-functional internal Legal practice group of subject matter experts on a range of provider-related issues

Candidate Education:

  • Required Other JD from accredited law school

Candidate Experience:

  • Required 5+ years of experience in Legal experience, heavily focused on health care provider issues, including sophisticated contracting, strategic partnerships/ACOs, payment systems and quality, medical economics and regulatory and reporting regimes applicable to provider relationships (e.g., prompt pay, anti-kickback, etc)
  • Required 5+ years of experience in Experience in this capacity with or on behalf of a multi-market MCO, and government programs experience, strongly preferred
  • Required 5+ years of experience in Strong financial acumen related to MCO and provider payment model economics is also strongly preferred.

Candidate Skills:

  • Intermediate Ability to communicate and make recommendations to upper management
  • Intermediate Ability to drive multiple projects
  • Intermediate Ability to effectively present information and respond to questions from peers and management
  • Advanced Ability to work in a fast paced environment with changing priorities
  • Advanced Ability to work in a matrixed environment
  • Intermediate Demonstrated analytical skills
  • Intermediate Demonstrated leadership skills
  • Intermediate Demonstrated problem solving skills
  • Intermediate Demonstrated negotiation skills
  • Intermediate Ability to influence internal and external constituents
  • Intermediate Ability to work as part of a team
  • Advanced Ability to work independently
  • Intermediate Knowledge of healthcare delivery

Licenses and Certifications:
A license in one of the following is required:

  • Required Other Licensed to practice law in state of office residence or get licensed

Technical Skills:

  • Preferred Intermediate Microsoft Excel
  • Preferred Intermediate Microsoft PowerPoint
  • Required Intermediate Microsoft Outlook
  • Preferred Intermediate Other Emptoris or other contracting systems
  • Required Intermediate Microsoft Word

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