Associate General Counsel - Pharmacy, Revenue Cycle, Payor Support

Posted 5 Days Ago
Be an Early Applicant
85258, Scottsdale, AZ, USA
In-Office
Senior level
Healthtech
The Role
Provide legal counsel for healthcare operations including contracts, managed care reimbursement disputes, regulatory compliance (Medicare/Medicaid, Stark, Anti‑Kickback), fraud and abuse analysis, policy review, claims management, and oversight of junior legal staff. Coordinate with outside counsel and advise leadership across the organization.
Summary Generated by Built In

Primary City/State:

HonorHealth - 8125 N Hayden Rd Scottsdale, AZ 85258

Category:

Legal Services

Shift:

Day

Department:

Legal

Hours: Monday-Friday Days

Location: Hybrid -- 1-2 days in the office per week

Ideal candidates for this role will have relevant contracting experience in a hospital or health system setting, healthcare environment, or law firm that specializes in managed care, pharmaceutical business, including 340B programs, and with strong preference being the hospital or health system setting. Experience negotiating terms and resolving disputes with managed care organizations related to reimbursement rates, utilization management, prior authorization procedures, network participation and challenging denials of prior authorization requests for necessary medical treatments. Ensure organizational compliance with all relevant laws, regulations, and industry standards in managed care and pharmaceutical operations.

Great care starts with great people. (Like you.)

At HonorHealth, you’ll find something special. From humble beginnings in 1927 to one of Arizona’s largest nonprofit healthcare systems, our culture is built on warmth and neighborly kindness. Behind every smile is a highly skilled professional with deep expertise and an unwavering dedication to what matters most — caring for the health and well-being of people and communities across the greater Phoenix area.

Responsibilities:

JOB SUMMARY
The Associate General Counsel is responsible for advising on a wide variety of legal matters, including contract language, affiliations, labor and employment laws, leases, medical staff matters, and fraud and abuse analysis.
ESSENTIAL FUNCTIONS
  • Provides primary support to designated areas of the organization on legal issues, including support on strategic transactional matters, review and response to claims, providing advice to staff, and review of policy revisions to comply with federal and state requirements. Manages and coordinates with outside counsel on claims and transactions as needed.
  • Researches a broad range of laws and regulations affecting the organization, including but not limited to federal and state laws and regulations affecting the business of healthcare facilities; Medicare, Medicaid, fraud and abuse, Stark Law, Anti-Kickback Statute, and antitrust issues; procurement; conflict of interest; compliance; tax-exempt issues; labor and employment; and affirmative action. Prepares legal memoranda as requested.
  • Drafts, negotiates, and reviews contracts and related documents, including for the provision of health care and related services, procurement of goods and services, affiliation with other institutions, confidentiality of proprietary information, physician employment and services, leases of space and equipment, software licenses, and electronic transmission of healthcare data.
  • Provides general legal advice and direction to the organization’s family of companies, senior management, the medical staff, leadership and employees on a wide variety of matters to resolve operational issues, including patient related situations.
  • Oversees the work of one or more legal professionals (e.g., staff attorneys, paralegals, or coordinators).
  • Performs other duties as assigned.
 
EDUCATION
  • Doctorate JD Juris Doctorate Required
 
EXPERIENCE
  • 8 years in healthcare related legal experience. Required
 
LICENSE AND CERTIFICATIONS
  • Registered as an attorney with the Supreme Court of Arizona and be licensed to appear and practice in all courts and agencies in the State of Arizona or licensed to practice in another state and registered as in-house counsel with Arizona bar with full registration and licensure in Arizona within twelve (12) months of hire. Required

We're all in for your career.

Skills Required

  • Doctorate JD Juris Doctorate
  • 8 years healthcare-related legal experience
  • Registered as an attorney with the Supreme Court of Arizona or registered as in-house counsel with Arizona bar with full licensure within 12 months
  • Contracting experience in hospital or health system setting or law firm specializing in managed care or pharmaceutical business including 340B programs
  • Experience negotiating with managed care organizations on reimbursement, utilization management, prior authorization, network participation, and denial challenges
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The Company
HQ: Scottsdale, AZ
6,300 Employees
Year Founded: 2013

What We Do

This practice is a dedicated team of electrophysiologists, physician assistants, nurses and technicians, who as a group, are committed to treating and caring for patients experiencing problems with their heart's rhythm and electrical signaling.

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