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<p>Provides advice and counsel to the healthcare-related departments including, but not limited to, Provider Services, Medical Management, Program Integrity, and Claims. The candidate will draft, review and participate in negotiating contracts with providers and other organizations with a goal of achieving acceptable risk levels. The candidate should also have experience with regulatory matters, including Medicare and Medicaid and conditions of participation in federal healthcare programs, anti-kickback laws, self-referral laws and HIPAA. Experience in fraud and abuse work and experience with corporate and transactional matters for health care providers is preferred.</p>
<p><b><i> **Veterans, Reservists, Guardsmen, and military family members are encouraged to apply**</i></b></p>
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<p><b><br> Education & Experience</b></p>
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<p><b> Required:</b></p>
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<li>Juris Doctor degree from an accredited law school</li>
<li>License to practice in the State of Arizona</li>
<li>4+ years legal experience in healthcare or related field</li>
<li>Excellent written and verbal communication skills</li>
<li>Experience advising managed care administrators, health plans, or healthcare providers,</li>
<li>Familiarity with HIPAA, False Claims Act, Stark, Anti-Kickback and other healthcare-related laws & regulations</li>
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<p><b> Preferred </b></p>
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<li>Familiarity with government-funded healthcare programs </li>
<li>Familiarity with VA and DoD healthcare programs </li>
<li>Prior experience with federal government contracting </li>
<li>Experience reviewing, drafting, and negotiating commercial contracts, including technology agreements</li>
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<p><b> Key Responsibilities</b></p>
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<p><b> TriWest Associate General Counsel:</b></p>
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<li>Identifies and analyzes legal issues (including conducting legal research, identifying new or emerging areas of risk, etc.), presents clear recommendations, and ensures legal compliance.</li>
<li>Investigates researches and provides general legal advice on a broad range of issues arising from TriWest operations.</li>
<li>Reviews and develops documents and contracts as necessary including provider agreements, business associate agreements, transactions involving electronic health records, telehealth, and others as needs arise. </li>
<li>Assists in providing legal advice to departments and committees throughout TriWest on all health law issues, including fraud and abuse, privacy and security, and peer review privilege. </li>
<li>Drafts and reviews other miscellaneous legal documents and correspondence.</li>
<li>Researches current issues and developments related to government health care programs, health insurance and impact of existing and proposed healthcare regulations. </li>
<li>Performs legal research and prepares memoranda on other legal issues as assigned.</li>
<li>Assists with the development and monitoring of internal regulatory compliance procedures.</li>
<li>Reviews marketing materials, responses to grievances, routine and priority correspondence, and internal and external communications documents.</li>
<li>Functions on TriWest standing and ad hoc committees as a representative of the Legal department including, but not limited to, committees responsible for TriWest’s peer review, quality, and credentialing programs.</li>
<li>Assists with TriWest training and implementation to ensure legal compliance with requirements.</li>
<li>Reviews and revises Company policies and procedures.</li>
<li>Ensures that Company employees and committee members are aware of and in compliance with applicable laws and regulations. </li>
<li>Educates staff and committee members on legal requirements as appropriate.</li>
<li>Advises TriWest senior leadership of the legal ramifications of past and proposed company actions.</li>
<li>Performs other duties as assigned.</li>
<li>Regular and reliable attendance is required.</li>
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<p><b> Competencies</b></p>
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<p><b> Coaching / Training / Mentoring: </b>Actively foster actions required for desired business outcomes through ongoing constructive feedback.</p>
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<p><b><br> Communication / People Skills: </b>Ability to influence or persuade others under positive or negative circumstances; Adapt to different styles; Listen critically; Collaborate.</p>
<p><b> Computer Literacy: </b>Ability to function in a multi-system Microsoft environment using Word, Outlook, TriWest Intranet, the Internet, and department software applications.</p>
<p><b> Empathy / Customer Service: </b>Customer-focused behavior; Helping approach, including listening skills, patience, respect, and empathy for another's position.</p>
<p><b> Independent Thinking / Self-Initiative: </b>Critical thinkers with ability to focus on things which matter most to achieving outcomes; Commitment to task to produce outcomes without direction and to find necessary resources.</p>
<p><b> Information Management: </b>Ability to manage large amounts of complex information easily, communicate clearly, and draw sound conclusions.</p>
<p><b> Organizational Skills: </b>Ability to organize people or tasks, adjust to priorities, learn systems, within time constraints and with available resources; Detail-oriented.</p>
<p><b> Problem Solving / Analysis: </b>Ability to solve problems through systematic analysis of processes with sound judgment; Has a realistic understanding of relevant issues.</p>
<p><b> Technical Skills: </b>Proficiency in Microsoft Office (Word, Excel, Outlook)</p>
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<h2 class="jobSectionHeader"><b> Company Overview</b></h2>
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<p><b>Taking Care of Our Nation’s Veterans.</b></p>
<p><b> It’s Who We Are. It’s What We Do.</b></p>
<p> Do you have a passion for serving those who served?</p>
<p><b> Join the TriWest Healthcare Alliance Team! We’re On a Mission to Serve®!</b></p>
<p> Our job is to make sure that America’s heroes get connected to health care in the community.</p>
<p> At TriWest Healthcare Alliance, we’ve proudly been on that important mission since 1996. For more information about TriWest, please explore our website at www.triwest.com.</p>
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<h2 class="jobSectionHeader"><b> Benefits</b></h2>
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<p><b>More about working at TriWest Healthcare Alliance</b></p>
<p> We’re more than just a health care company. We’re passionate about serving others! We believe in rewarding loyal, hard-working people who are willing to learn as they grow. TriWest Healthcare Alliance values teamwork. Join our team, fulfill your responsibilities, and you may also be considered for frequent pay raises, overtime opportunities to earn even more, recognition and reward programs, and much more. Of course, we also offer a comprehensive and progressive compensation and benefits package that includes:</p>
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<li>Medical, dental and vision coverage</li>
<li>Generous paid time off</li>
<li>401(k) Retirement Savings Plan (with matching)</li>
<li>Short-term and long-term disability, basic life, and accidental death and dismemberment insurance</li>
<li>Education Reimbursement </li>
<li>Paid Volunteer Time</li>
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<h2 class="jobSectionHeader"><b> Equal Employment Opportunity</b></h2>
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<p>TriWest Healthcare Alliance is an equal employment opportunity employer. All qualified applicants are considered for employment, without discrimination on the basis of race, color, religion, sex, sexual orientation, gender identity, national origin, age, disability, veteran status, or any other characteristic made unlawful by applicable federal, state, or local laws.</p>
<p><b> Are you ready to make a difference in the lives of our nation’s heroes?</b></p>
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