Associate senior counsel - commercial medical network
Location
Bluffton, SC | United States
Job description
The Associate Senior Counsel position will provide strategic legal advice and counsel for a region of the Cigna US Commercial Medical Network contracting team (anticipated to be Mid-Atlantic and Liberty Valley) on a wide variety of medical provider contracting matters while working alongside the Network Regional Directors and other National Contracting leaders to support the US Medical Network business strategy.
The Associate Senior Counsel will take ownership of issues and coordinate with other parts of Legal and the business teams to reach successful solutions. As a member of the U.S. Medical Network Contracting team, the Associate Senior Counsel will provide legal advice and counsel on issues related provider contracting, pre-litigation provider objections and disputes regarding various programs, policies, and contractual interpretations, and support commercial contract initiatives and commercial contract governance. To be successful, this individual must have experience in the health care managed care/insurance industry and medical provider contracting and be able to collaborate within the business and across the broader Legal and Corporate Affairs team to drive the Network contracting strategy.
Responsibilities will include, but not be limited to:
- Lead counsel to regional U.S. Medical Network contracting teams, support Regional Vice President, Regional Directors, and Provider Contracting Directors across multiple states to ensure strategic business goals are met.
- Provide day-to-day legal support for network management, including strategy and advice on contracting approaches and considerations, interpretation of contract terms and alternative approaches, compliance with Cigna policies, problem solving and identifying solutions and options, and assistance with review of routine documents with respect to third parties such as NDAs, requests for consent to assignment or approval of change of ownership, termination notices, marketing communications, hold harmless agreements and antitrust submissions from consultants;
- Draft, review and negotiate complex provider agreement with an understanding of understanding business implications, risks, and potential regulatory or third party contractual considerations.
- Manage provider disputes and pre-litigation matters. Counsel business clients on potential outcomes of legal matters and assist with review, evaluation, and response to provider objections and notices of dispute in coordination with network leads, litigation and other matrix partners.
- Collaborate with key legal, compliance and business partners to address claims or contract issues, regulatory concerns, effect of new legislation, and assist with responses to regulators, clients or customers to mitigate negative effects and proactively promote alternative approaches and solutions.
- Provide support for various company initiatives, such as value-based contracting, strategic alliances, cost-savings strategies and policies, data sharing arrangements, electronic medical record access agreements, and other issues, often requiring close collaboration among legal, compliance, and business leadership across multiple business segment.
- Assist with review of provider termination notices and their compliance with state laws and the contract, and attend provider appeal hearings.
- Effectively collaborate with internal partners, including the network team, compliance, litigation, privacy, state regulatory affairs, government affairs, procurement, SIU and other business units and Cigna Affiliates to provide interpretative and practical advice on a variety of legal and business decisions.
Qualifications:
- Law degree; at least 8-10 years corporate legal department or law firm experience with a demonstrated background in medical provider contracting and the health care managed care/insurance industry.
- JD and Bar membership.
- Strong analytical and contract writing skills, strong negotiating skills and the ability to work with a high degree of independence.
- Ability to appropriately prioritize work and manage time effectively.
- Demonstrated good judgment and willingness to take on difficult projects.
- Ability to engage across a wide variety of business stakeholders to facilitate solutions.
- Ability to work effectively with a variety of matrix partners and team members.
- This is a Hybrid role with 50% of the time in office.
If you will be working at home occasionally or permanently, the internet connection must be obtained through a cable broadband or fiber optic internet service provider with speeds of at least 10Mbps download/5Mbps upload.
About The Cigna Group
Doing something meaningful starts with a simple decision, a commitment to changing lives. At The Cigna Group, we’re dedicated to improving the health and vitality of those we serve. Through our divisions Cigna Healthcare and Evernorth Health Services, we are committed to enhancing the lives of our clients, customers and patients. Join us in driving growth and improving lives.
Qualified applicants will be considered without regard to race, color, age, disability, sex, childbirth (including pregnancy) or related medical conditions including but not limited to lactation, sexual orientation, gender identity or expression, veteran or military status, religion, national origin, ancestry, marital or familial status, genetic information, status with regard to public assistance, citizenship status or any other characteristic protected by applicable equal employment opportunity laws.
If you require reasonable accommodation in completing the online application process, please email: [email protected] for support. Do not email [email protected] for an update on your application or to provide your resume as you will not receive a response.
The Cigna Group has a tobacco-free policy and reserves the right not to hire tobacco/nicotine users in states where that is legally permissible. Candidates in such states who use tobacco/nicotine will not be considered for employment unless they enter a qualifying smoking cessation program prior to the start of their employment. These states include: Alabama, Alaska, Arizona, Arkansas, Delaware, Florida, Georgia, Hawaii, Idaho, Iowa, Kansas, Maryland, Massachusetts, Michigan, Nebraska, Ohio, Pennsylvania, Texas, Utah, Vermont, and Washington State.
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