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Assistant General Counsel, Reimbursement: Sutter Health

Sutter Health Support Services (SHSS) is the Support Center for the Sutter Health affiliates, which houses all non-medical support departments that are not provided at the affiliates. It provides expertise and guidance to support affiliate functional departments. The Assistant General Counsel (AGC) position assists the Senior Vice President & General Counsel, other more senior attorneys, and members of Sutter Health / Affiliate management by providing legal advice and counsel (including conducting or overseeing legal research, identifying new or emerging areas of risk, etc.), on a range of topics within their general practice areas. The AGC role will have subject matter expertise in Reimbursement issues.


The incumbent must posses the ability to apply knowledge of healthcare reimbursement and compliance laws, regulations and standards to health system operations throughout the organization. The incumbent must have knowledge of Medicare and Medi-Cal requirements for both facility and physician reimbursement and the False Claims Act. Experience advising on facility licensure, health professional scope of practice and Medicare conditions of participation desired.

The AGC will also assist the Deputy General Counsel in managing the work of outside counsel, experts and consultants to ensure quality and consistency of legal and consulting advice provided to the Office of the General Counsel (OGC) and other internal clients. The position requires attention to detail and the ability to work independently. This position also requires consulting and collaboration experience and expertise in support of department and system-wide projects, workgroups, and initiatives.

Education:
Must possess a Juris Doctor degree from an accredited law school.

Licensure:
Must be a member in good standing with a state bar.
A member in good standing with the State Bar of California is desired.

Experience:
Must have demonstrated at least 6 years of providing legal analysis and advice relative to Medicare and Medi-Cal reimbursement including hospital inpatient and outpatient services, physician services, post-acute care and the appeals process. Must have experience of interpreting and applying the False Claims Act. Experience analyzing reimbursement issues related to clinical research is preferred.

Special Skills:
Candidate must demonstrate excellent written and verbal communication skills as well as the ability to translate legal complexities into terms readily understood by management and line personnel. Must have demonstrated initiative and an ability to work in a fast paced complex matrixed managed organization. Candidate must be able to demonstrate strong client management and project management skills as well as the ability to work successfully both independently and within a team.

Other:
The Assistant General Counsel is not allowed a private law practice with the exception of pro bono activities performed outside the scope of this position.

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