Senior Counsel / Assistant Vice President, Legal ...

Job Title and DetailsSenior Counsel / Assistant Vice President, Legal Affairs, Managed Care ContractingReq #: 0000206244Category: Professional / ManagementStatus: Full-TimeShift: DayFacility: RWJBarnabas Health Corporate ServicesDepartment: General Counsel OfficePay Range: $175,000.00 - $295,000.00 per yearLocation:95 Old Short Hills Road, West Orange, NJ 07052 Job Overview RWJBarnabas Health, New Jersey's largest integrated academic healthcare system, seeks an experienced, detail-oriented, and strategic in-house attorney to serve as Assistant Vice President of Legal Affairs with a concentration in managed care contracting. This role will focus on legal matters involving managed care and payer contracting, value-based reimbursement models, and contract negotiation strategies. The successful candidate will provide legal and business guidance on complex contractual and regulatory issues relating to payor relationships, third-party administrators, Medicare Advantage, and Medicaid Managed Care. This position requires at least 8 years of relevant legal experience, preferably within a large health system, payor organization, law firm, or consulting firm with a focus on healthcare transactions and managed care contracting. Reporting The Assistant Vice President of Legal Affairs, Managed Care Contracting reports to the Vice President of Legal Affairs. Qualifications Juris Doctor from an accredited law school Active license to practice law in the State of New Jersey or eligibility for in-house counsel licensure in NJ Minimum of 8 years of relevant legal experience, with a strong preference for candidates with in-house healthcare system or managed care organization experience Deep expertise in managed care contracting, health plan operations, and regulatory frameworks governing provider-payer relationships Demonstrated ability to negotiate high-stakes contracts with a strong grasp of both legal risk and business priorities Excellent verbal and written communication skills, with a proactive and collaborative work style Experience with value-based payment models and risk arrangements Familiarity with contract lifecycle management systems and legal operations software Background in or understanding of healthcare economics, reimbursement methodologies, and health system finance Essential Functions Contract Drafting, Negotiation, and Review Draft, negotiate, and review a broad array of managed care and value-based contracts, including commercial and government payor agreements, provider network participation agreements, third-party administrator contracts, and delegated credentialing agreements Advise on contract language interpretation and terms related to reimbursement, risk-sharing, quality performance metrics, dispute resolution, and termination rights Coordinate with managed care, revenue cycle, finance, population health, compliance, and operational leadership teams to ensure alignment with system goals and financial impact Regulatory and Legal Compliance Monitor and interpret federal and state regulatory developments affecting managed care arrangements, including ERISA, HIPAA, No Surprises Act, CMS guidance, and New Jersey mandates Ensure contracts and payor strategies remain compliant with applicable laws and regulations Advise on value-based care models and alternative payment arrangements in accordance with fraud and abuse laws (e.g., Anti-Kickback Statute, Stark Law, and state equivalents) Internal Legal Support and Business Strategy Serve as a trusted advisor to system leadership, balancing risk mitigation with business objectives Identify legal risks and propose compliant solutions that support health system initiatives and partnerships Participate in cross-functional teams focused on managed care strategy, payment innovation, and implementation of contractual terms Administrative and Team Responsibilities Maintain accurate documentation and tracking of all managed care agreements and legal files Provide training to internal stakeholders regarding contract provisions, regulatory changes, and negotiation strategies Contribute to departmental initiatives around process improvement, contract lifecycle management, and legal operations Other Duties Please note this job description is not designed to cover all activities, duties or responsibilities required. Duties may change at any time with or without notice. Benefits and Perks At RWJBarnabas Health, our employees are at the heart of everything we do. Our Total Wellbeing offerings include comprehensive benefits and resources to support physical, emotional, financial, personal, career, and community wellbeing. These benefits include, but are not limited to: Paid Time Off (PTO) Retirement Plans Medical and Prescription Drug Insurance Dental and Vision Insurance Disability and Life Insurance Paid Parental Leave Tuition Reimbursement Health Care/Dependent Care Flexible Spending Accounts Wellness Programs Voluntary Benefits (e.g., Pet Insurance) Discounts Through partners (e.g., NJ Devils, NJ PAC, Verizon) and more Equal Opportunity Employer RWJBarnabas Health is an Equal Opportunity Employer #J-18808-Ljbffr

Created: 2025-09-29