Attorney Managed Care & Pharmacy

FROEDTERT HEALTH GROUP • Menomonee Falls, WI • 8h ago

JOB REQUIREMENTS: Discover. Achieve. Succeed. #BeHere Location: US:WI:MENOMONEE FALLS at our CP-TOWN HALL HEALTH CENTER or NEENAH at our THEDACARE CORPORATE OFFICES or WAUWATOSA at our FROEDTERT HOSPITAL. This job is HYBRID. Mixture of remote and in-office including being on site as needed. Residency in the State of Wisconsin within driving proximity of office locations in Milwaukee County and Outagamie County, Wisconsin required. FTE: 1.000000 Shift: Shift 1 Froedtert ThedaCare health (FTCH) is a \$6 Billion, integrated non-profit health care system that employs over 25,000 people and treats 43% of the population of the state of Wisconsin. FTCH has a large, academic medical center in partnership with the Medical College of Wisconsin and a wholly owned health plan. It is proud to serve its communities with Level 1 and 2 Trauma Centers, critical access and community hospitals, multi-disciplinary clinics, and a comprehensive offering of post-acute services. FTCH expects excellence and consistently achieves top decile quality performance. This is your chance to be part of a dynamic, innovative in-house team in an organization that is transforming healthcare in Wisconsin. Job Summary: Reporting to the Vice President, General Counsel (Corporate), primary legal support for the oversight, management, and administration of the drafting, review, and negotiation of all system contracts with managed care organizations (MCOs) and pharmaceutical-related entities, including 340B programs, for Froedtert ThedaCare Health, Inc. (FTCH). Works closely with and serves as the legal business partner for internal contract stakeholders and other organization leaders in support of the MCOs and pharmacy business, consistent with FTCH mission, vision, and enterprise values. Responsible for dispute resolution, litigation, and arbitrations in areas of focus, and ensuring compliance with managed care and pharmaceutical regulations, including 340B regulations, STARK and anti-kickback statutes. Additional responsibilities include providing legal oversight, management, and administration of the drafting, review, and negotiation of additional key transactions, as assigned, for FTCH internal contract stakeholders and other organization leaders, consistent with FTCH mission, vision, and enterprise values, including dispute resolution related thereto. Provide legal guidance and risk management counseling and retain and manage outside counsel as needed within defined budges, in areas of responsibility. Be an integral part, and advance the leadership, oversight, and efficiency, of the FTCH Office of General Counsel (OGC) contracting team tasked with interpreting, drafting, reviewing and negotiating contracts, including mentoring, performance management, and ensuring delivery of high-quality contracting team-related legal services. EXPERIENCE DESCRIPTION: 5-8 years of relevant contracting experience in a hospital or health system setting, healthcare environment, or law firm that specializes in managed care, pharmaceutical business, including 340B and pharmacy benefit manager programs, with strong preference being the hospital or health system setting. Experience negotiating terms and resolving disputes with MCOs 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. EDUCATION DESCRIPTION: Juris Doctorate (JD) from an accredited law school is required. REGULATORY DESCRIPTION: Deep understanding of federal and state laws governing managed care, including ERISA, HIPAA, and Wisconsin-specific regulations is required. SPECIAL SKILLS *** APPLICATION INSTRUCTIONS: Apply Online: https://www.aplitrak.com/?adid=YmJnZW5lcmljLjE4MzI0Ljg3NzBAZnJvZWR0ZXJ0Y29tcC5hcGxpdHJhay5jb20

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