Attorney Managed Care & Pharmacy Office of General Counsel (Menomonee Falls)

Attorney Managed Care & Pharmacy Office of General Counsel

Location : US : WI : MENOMONEE FALLS at our CP-TOWN HALL HEALTH CENTER facility

Work Type : Full-time. This job is HYBRID.

Shift : 1st

Job Summary :

Responsible for the legal 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) internal contract stakeholders and other organization leaders, consistent with the FTCH mission, vision, and enterprise values, including dispute resolution, and compliance therewith to managed care regulations. Responsible for the 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 the FTCH mission, vision, and enterprise values, including dispute resolution related thereto.

EXPERIENCE DESCRIPTION :

Must have a minimum of 4 years of relevant contracting experience in a hospital or health system setting, healthcare environment, or law firm that specializes in managed care, 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. 5-8 years of relevant contracting experience in a hospital or health system setting, healthcare environment, or law firm that specializes in managed care, with strong preference being the hospital or health system setting is preferred.

EDUCATION DESCRIPTION :

A Juris Doctorate (JD) from an accredited law school is required.

TRAINING DESCRIPTION :

Deep understanding of federal and state laws governing managed care, including ERISA, HIPAA, and Wisconsin-specific regulations is required.

SPECIAL SKILLS DESCRIPTION :

Strong leadership communication and management skills. Strong project management skills. Excellent legal research and writing skills. Strong attention to detail. Ability to work independently and as part of a team. Effective communication and interpersonal skills. Proficiency in legal software and Microsoft Office Suite. Commitment, value, excellence, and professional development.

LICENSURE DESCRIPTION :

Licensed to practice law as in-house counsel and in good standing in the State of Wisconsin or be eligible to seek admission to practice in Wisconsin upon hire is required.

Perks & Benefits at Froedtert Health

Froedtert Health Offers a variety of perks & benefits to staff, depending on your role you may be eligible for the following :

Paid time off

Growth opportunity- Career Pathways & Career Tuition Assistance, CEU opportunities

Academic Partnership with the Medical College of Wisconsin

Referral bonuses

Retirement plan - 403b

Medical, Dental, Vision, Life Insurance, Short & Long Term Disability, Free Workplace Clinics

Employee Assistance Programs, Adoption Assistance, Healthy Contributions, Care@Work, Moving Assistance, Discounts on gym memberships, travel and other work life benefits available

The Froedtert & the Medical College of Wisconsin regional health network is a partnership between Froedtert Health and the Medical College of Wisconsin supporting a shared mission of patient care, innovation, medical research and education. Our health network operates Eastern Wisconsin's only academic medical center and adult Level I Trauma center engaged in thousands of clinical trials and studies. The Froedtert & MCW health network, which includes ten hospitals, nearly 2,000 physicians and more than 45 health centers and clinics draw patients from throughout the Midwest and the nation.