Associate General Counsel III, Provider Contracting

Job Description

Job Description

Medica is a nonprofit health plan with more than a million members that serves communities in Minnesota, Nebraska, Wisconsin, Missouri, and beyond. We deliver personalized health care experiences and partner closely with providers to ensure members are genuinely cared for.

We're a team that owns our work with accountability, makes data-driven decisions, embraces continuous learning, and celebrates collaboration — because success is a team sport. It's our mission to be there in the moments that matter most for our members and employees. Join us in creating a community of connected care, where coordinated, quality service is the norm and every member feels valued.

Medica is seeking to hire an Associate General Counsel III to join our Legal Department and support our Provider Network contracting team. Our General Counsel provides legal advice and services on issues concerning the rights, obligations, and privileges of the organization. This role will protect the organization's rights in contract negotiations, settlements and dispute resolution, and provide a full range of legal advice and services and may specialize in one of more areas of law: insurance, health, government programs, commercial, contracts, benefit, anti-trust investigations, tax law, regulatory and compliance. Performs other duties as assigned.

Key Accountabilities

• Draft provider contract templates, amendments, including value-based payment provisions
• Be the first point of contact for Network contract managers with provider contract template questions and requests for assistance with counterproposal language
• Negotiate directly with provider legal counsel
• Give legal support for provider quality of care and FWA investigations and regulatory complaint responses involving providers
• Advise and engage in dispute resolution on claims payment issues with providers
• Research State/Federal laws, regulations, and sub-regulatory guidance

Required Qualifications

• J.D. degree from an ABA-accredited law school and a current license to practice law in at least one United States jurisdiction
• 5+ years of work experience beyond degree
• Contract experience and negotiation experience 

Required Certifications/Licensure

• J.D. degree from an ABA-accredited law school and a current license to practice law in at least one United States jurisdiction

Preferred Qualifications

• Experience within the healthcare, health insurance or insurance industry. Experience from heavily regulated industries such as banking, financial services, etc. will also be considered.
• Knowledge of ERISA and HIPAA preferred
• Experience building and maintaining a rapport with internal clients and external business partners

Skills and Abilities

• Strong Project Management skills – able to organize, document, manage and improve complex department processes, workflows, and shared resources
• Excellent writing, editing, and proofreading skills and experience working with contracts, templates or other legal documentation to include review, interpretation, editing, creation. 
• Well-developed analytical and problem-solving skills
• Able to independently analyze complex business issues and provide solution recommendations based on an accurate interpretation of the law
• Situationally aware, able to apply consistent judgment to seek decision support from their manager and or the legal team
• Will be required to leverage the expertise of Medica department leads, this position needs to build strong working rapport with internal and external teams
• Maintains focus on time sensitive deliverables and under sometimes stressful circumstances and rapid changes in demand, can appropriately re-prioritize tasks and projects

This position is an Office role, which requires an employee to work onsite, on average, 3 days per week. We are open to candidates located near one of the following office locations: Minneapolis, MN, Madison, WI, Omaha, NE, St. Louis, MO. 

The full salary grade for this position is $130,300 - $223,400. While the full salary grade is provided, the typical hiring salary range for this role is expected to be between $130,300 - $195,510. Annual salary range placement will depend on a variety of factors including, but not limited to, education, work experience, applicable certifications and/or licensure, the position's scope and responsibility, internal pay equity and external market salary data.  In addition to base compensation, this position may be eligible for incentive plan compensation in addition to base salary. Medica offers a generous total rewards package that includes competitive medical, dental, vision, PTO, Holidays, paid volunteer time off, 401K contributions, caregiver services and many other benefits to support our employees.

The compensation and benefits information is provided as of the date of this posting. Medica’s compensation and benefits are subject to change at any time, with or without notice, subject to applicable law.

Eligibility to work in the US: Medica does not offer work visa sponsorship for this role. All candidates must be legally authorized to work in the United States at the time of application. Employment is contingent on verification of identity and eligibility to work in the United States.

We are an Equal Opportunity employer, where all qualified candidates receive consideration for employment indiscriminate of race, religion, ethnicity, national origin, citizenship, gender, gender identity, sexual orientation, age, veteran status, disability, genetic information, or any other protected characteristic.