Senior Counsel- Government Segment Regulatory

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Senior Counsel- Government Segment Regulatory
Responsibilities: Provide strategic legal regulatory advice and counsel to **MEMBERS ONLY**SIGN UP NOW***. Government Business Segment products and services on Medicare Program Parts A, B, C, and D. Provide interpretative and practical advice regarding oversight and compliance requirements of the Medicare Advantage and Medicare Prescription Drug programs. Advise Government Business on compliance, risk adjustment; Star ratings; medical loss ratio and other financial and reporting requirements; internal investigations; fraud and abuse and managing government disclosures. Serve as lead lawyer for in responding to government audits and investigations. Serve as subject matter expert on federal health care laws and regulation, regulatory and enforcement environment affecting the business, including federal and state anti-kickback and self-referral laws, fraud and abuse, False Claims Act liability, government payor billing and reimbursement requirements and payment, government audits, and compliance programs. Advises on the development of business arrangements to assure compliance with federal and state fraud and abuse laws, including the discount, managed care and group purchasing organizations safe harbors. Collaborates with the business team and enterprise colleagues on the impact and response to proposed and new rules, regulations and legislation. Work closely with business Operations and Compliance to identify and reduce known and potential regulatory, legal and business risks. Design and implement measures to avoid, reduce and mitigate risks.

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