Senior Counsel - Healthcare and Corporate

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Full Time Pasadena, CA, US

4 days ago Requisition

Salary Range: $ To $ Annually

Position Overview

Imperial Health is seeking an experienced, practical and business-oriented attorney to join the organization as Corporate Counsel – Healthcare.

This is a broad, hands-on in-house legal role supporting Imperial's health plans and affiliated healthcare businesses. The attorney will work closely with executive leadership, Compliance, Human Resources, Finance, Operations, Claims, Network/Provider Relations and other business teams and will coordinate with Imperial's outside counsel in California and other states.

The successful candidate will be comfortable independently managing a wide variety of legal matters—from contracts and provider disputes to regulatory matters, employment issues, settlements, arbitrations and litigation—while recognizing when specialized outside counsel should be engaged.

This position is intended for an attorney who wants to own matters rather than simply refer them to outside counsel
.

Key Responsibilities

• Serve as a principal internal legal resource for Imperial's health plans and affiliated healthcare businesses on day-to-day legal and business matters.
• Manage litigation, arbitration and pre-litigation disputes
  , including provider and reimbursement disputes, contract disputes, employment matters and other commercial claims.
• Evaluate claims and disputes, develop strategy, coordinate internal factual investigations and document collection, supervise discovery, and work directly with outside litigation counsel.
• Negotiate and resolve claims and settlements
  , including evaluating legal and financial exposure, developing settlement strategy, negotiating settlement terms and preparing or reviewing settlement and release agreements.
• Manage outside counsel in California and other states
  , including selecting appropriate counsel, defining scope and strategy, reviewing work product, monitoring deadlines and controlling legal spend.
• Draft, review and negotiate contracts, including provider agreements, Letters of Agreement (LOAs), vendor and services agreements, NDAs, BAAs, technology agreements, consulting agreements and other healthcare and commercial contracts
  .
• Advise on provider contracting, reimbursement, claims-payment disputes, contract interpretation, network matters and related managed-care issues.
• Partner closely with Compliance on regulatory inquiries, investigations, compliance issues, corrective actions, policies and procedures, and implementation of federal and state regulatory requirements.
• Assist with matters involving CMS, DMHC, state Departments of Insurance and other federal and state regulators
  , coordinating with regulatory counsel where appropriate.
• Support legal and regulatory matters associated with Imperial's operations and expansion into multiple states.
• Partner with Human Resources on internal employment matters, including employee complaints, investigations, disciplinary matters, terminations, accommodations, employment agreements and threatened employment claims, with specialized employment counsel engaged when appropriate.
• Support enterprise risk management
  , including identifying emerging legal exposures, evaluating potential liability, assisting with insurance-related matters and developing strategies to mitigate legal and operational risk.
• Respond to or oversee responses to demand letters, subpoenas, regulatory inquiries, complaints and other formal legal communications.
• Advise business teams on healthcare laws and regulations affecting health-plan and healthcare…