Associate General Counsel Regulatory Affairs and Compliance

Associate General Counsel Regulatory Affairs and Compliance

Discover Vanderbilt University Medical Center: Located in Nashville, Tennessee, and operating at a global crossroads of teaching, discovery, and patient care, VUMC is a community of individuals who come to work each day with the simple aim of changing the world. It is a place where your expertise will be valued, your knowledge expanded, and your abilities challenged. Vanderbilt Health is committed to an environment where everyone has the chance to thrive and where your uniqueness is sought and celebrated. It is a place where employees know they are part of something that is bigger than themselves, take exceptional pride in their work and never settle for what was good enough yesterday. Vanderbilt's mission is to advance health and wellness through preeminent programs in patient care, education, and research.

The Vanderbilt Health Executive Search Team is conducting a national search for an Associate General Counsel Regulatory Affairs and Compliance. The Associate General Counsel Regulatory Affairs and Compliance provides a broad range of legal support to Vanderbilt Health's operations serves as a key legal advisor supporting the academic medical center, regional hospitals, and affiliated healthcare entities. This attorney provides strategic and practical legal counsel regarding healthcare regulatory compliance, physician relationships, quality and value-based care initiatives, conflicts of interest, and clinically integrated network (CIN) operations. The position works closely with executive leadership, compliance, clinical enterprise, population health, quality, and operational stakeholders to manage legal and regulatory risk while advancing the organization's clinical, academic, and strategic objectives.This role is responsible for collaborating with Vanderbilt Health departments and divisions, delivering timely legal guidance advising on compliance matters that impact Vanderbilt Health, and for collaborating as an active and engaged team member in support of the Office of Legal Affairs. The successful candidate will be a strategic thinker, an approachable adviser, and a collaborative relationship-builder who thrives in an intellectually challenging environment and demonstrates alignment with Vanderbilt Health's values.

General Responsibilities:

• Provide legal analysis and counsel on state and federal and compliance rules and regulations, including, without limitation, Physician Self-Referral Law (Stark), Anti-kickback Statute, Civil Monetary Penalties law, False Claims Act, Medicare and Medicaid reimbursement requirements.
• Provide support for healthcare reporting programs, including hospital inpatient and outpatient quality reporting, MACRA/MIPS and Alternative Pay models, other payor driven quality metrics.
• Provide advice on evolving federal and state regulatory requirements, interpret statutes, regulations and guidance impacting quality reporting obligations.
• Participate in compliance reviews, internal investigations, corrective action activities, and regulatory assessments.
• Provide support for conflict-of-interest disclosure process including review, analysis and resolution of potential conflicts involving employed and community physicians to ensure compliance with applicable regulatory requirements and organizational policies.
• Collaborate with compliance department to provide advice on federal and state regulatory requirements impacting Advanced Practice Providers including state licensing board, including compliance risks related to expired or inadequate licensure, scope of practice misalignment, improper supervision, provide resolution strategies, including corrective action plans and collaborate with other department attorneys to support investigations into potential licensure violations, support compliance department audits of APP licensure compliance.
• Provide regulatory guidance to Vanderbilt Health's clinically integrated network and Accountable Care Organizations supporting value base care initiatives. Guidance includes advising on federal and state laws governing CINs and ACO models including clinical and financial network integration, legal structuring and governance of CINs and ACOs, care management and shared savings distribution models, assess contracts for compliance with fraud and abuse laws, FMV, and commercial reasonableness.
• Provide legal counsel and compliance oversight for Vanderbilt Health's ambulance operations, including both ground and air ambulance services, including advising on Medicare and Medicaid ambulance coverage and reimbursement rules, proper billing practice for ambulance services and coordinating with outside counsel resources as needed to support the work, including oversight of air ambulance services.
• Provided legal and regulatory guidance on revenue cycle operations, including patient billing, coding, documentation, charge capture, reimbursement, and collections, to support compliance with federal and state healthcare laws.
• Such other matters as requested by General Counsel and Managing Counsel
• Participate as requested in support of Office of Legal Affairs initiatives.
• Participate in the on-call rotation for night and weekend OLA call coverage.

Qualifications:

• JD degree from an ABA accredited law school.
• Employment contingent upon State of Tennessee licensure or registration and receipt of In-House Counsel Practice Certificate. The successful candidate must also apply for and become licensed in the State of Tennessee within 12 months of employment or, if earlier, the date required under applicable rules of the Tennessee Supreme Court.

Preferred Qualifications:

• Ten (10) or more years of progressively responsible legal experience related to healthcare compliance.
• Experience within an academic medical center or large health system preferred.
• Demonstrated ability to advise leadership on sophisticated, time?sensitive healthcare matters.
• Strong ability to identify, assess, and mitigate legal risks associated with healthcare matters.
• Exceptional interpersonal and communication skills, including negotiation and the ability to educate non?legal stakeholders.
• Demonstrated ability to build trust and credibility with clinical faculty, staff, administrators, and senior leadership.
• Proven commitment to confidentiality, discretion, and high ethical standards.
• Ability to stay current with evolving laws, regulations, and enforcement trends.
• Experience facilitating policy review, development, and institutional adoption.
• Ability to effectively represent institutional interests internally and externally.

Our professional administrative functions include critical supporting roles in information technology and informatics, finance, administration, legal and community affairs, human resources, communications and marketing, development, facilities, and many more.

At our growing health system, we support each other and encourage excellence among all who are part of our workforce. High-achieving employees stay at Vanderbilt Health for professional growth, appreciation of benefits, and a sense of community and purpose.

Core Accountabilities:

* Organizational Impact: Implements strategies for a sub function with direct impact to the function results.

* Problem Solving/ Complexity of work: Resolves highly complex business issues that are often unprecedented that have immediate impact on own sub-function or entity and wider implications to the organization.

* Breadth of Knowledge: Applies expertise within professional/technical area and uses advanced business knowledge to develop objectives.

* Team Interaction: Leads a sub-function serving the organization at large or across one or more entity(s).

Core Capabilities :

Supporting Colleagues: - Develops Self and Others: Acts upon constructive feedback from all levels of the organization and initiates strategies to develop talent in others. - Builds and Maintains Relationships: Leverages relationships and insight to forecast potential future needs and influence delivery of work to exceed expectations. - Communicates Effectively: Anticipates difference audience concerns, styles and finds mutually beneficial solutions across conflicting and sensitive issues. Delivering Excellent Services: - Serves Others with Compassion: Demonstrates in-depth knowledge of broad-based issues and considers the interests of others to improve satisfaction of services. - Solves Complex Problems: Critically evaluates complex information and identifies trends/risks to make recommendations to improve processes across areas. - Offers Meaningful Advice and Support: Provides ongoing feedback and development discussions to motivate and support team members to maximize performance. Ensuring High Quality: - Performs Excellent Work: Anticipates problems or obstacles which may interfere with quality standards and develops plants to ensure area's quality standards are met. - Ensures Continuous Improvement: Routinely draws upon valuable learning from others, past experiences, and new information to determine key opportunities. - Fulfills Safety and Regulatory Requirements: Develops appropriate corrective actions for unsafe environments in order to ensure operational and safety compliance. Managing Resources Effectively: - Demonstrates Accountability: Identifies potential obstacles to goal achievement and develops solutions to address those obstacles. - Stewards Organizational Resources: Creates the appropriate systems and processes to effectively manage resources. - Makes Data Driven Decisions: Applies in-depth knowledge of data to recommend and implement new approaches to improve decision making capabilities. Fostering Innovation: - Generates New Ideas: Identifies opportunities and leads development of new initiatives that create value across areas. - Applies Technology: Creates the energy and drive for self/others to identify and leverage technology in new, innovative ways to drive greater efficiencies. - Adapts to Change: Anticipates the change process and clearly communicates impact on others/own team(s), assisting them in embracing the change.

Position Qualifications:

Responsibilities:

Certifications:

Work Experience:

Experience Level:

Education:

Master's

This role offers the opportunity to make a meaningful impact within Vanderbilt Health, supported by a comprehensive benefits package which may include health, disability, retirement and/or wellness offerings to enhance your well-being and professional growth.

Vanderbilt Health is committed to fostering an environment where everyone has the chance to thrive and is committed to the principles of equal opportunity. EOE/Vets

Vanderbilt University Medical Center