RWJBarnabas Health
Senior Counsel / Assistant Vice President, Legal Affairs, Managed Care Contracti
RWJBarnabas Health, Short Hills, New Jersey, us, 07078
Job Title
Senior Counsel / Assistant Vice President, Legal Affairs, Managed Care Contracting
Location RWJBarnabas Health Corporate Services, 95 Old Short Hills Road, West Orange, NJ 07052
Pay Range $175,000.00 - $295,000.00 per year (New Jersey)
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.
Reporting Line 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 the ability to convey attention to detail, 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 strategic terms related to reimbursement, risk‑sharing, quality performance metrics, dispute resolution, and termination rights
Coordinate closely 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 but not limited to ERISA, HIPAA, the No Surprises Act, CMS guidance, and New Jersey‑specific mandates
Ensure that contracts and payor strategies remain in compliance with all applicable laws and regulations
Advise on value‑based care models and alternative payment arrangements in accordance with fraud and abuse laws, including the federal Anti‑Kickback Statute, Stark Law, and state equivalents
Internal Legal Support and Business Strategy
Serve as a trusted advisor to system leadership, offering practical legal counsel that balances risk mitigation with business objectives
Proactively identify areas of legal risk and propose creative, legally compliant solutions that promote health system initiatives and strategic partnerships
Participate in cross‑functional teams focused on managed care strategy, payment innovation, and operational implementation of contractual terms
Administrative and Team Responsibilities
Maintain accurate documentation and tracking of all managed care agreements and associated legal files
Provide training and education 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 or contain a comprehensive listing of activities, duties or responsibilities that are required of the employee for this job. Duties, responsibilities and activities may change at any time with or without notice.
Benefits and Perks
Paid Time Off including Vacation, Holidays, and Sick Time
Retirement Plans
Medical and Prescription Drug Insurance
Dental and Vision Insurance
Disability and Life Insurance
Paid Parental Leave
Tuition Reimbursement
Student Loan Planning Support
Flexible Spending Accounts
Wellness Programs
Voluntary Benefits (e.g., Pet Insurance)
Community and Volunteer Opportunities
Discounts Through our Partners such as NJ Devils, NJ PAC, and Verizon
...and more!
RWJBarnabas Health is an Equal Opportunity Employer
#J-18808-Ljbffr
Location RWJBarnabas Health Corporate Services, 95 Old Short Hills Road, West Orange, NJ 07052
Pay Range $175,000.00 - $295,000.00 per year (New Jersey)
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.
Reporting Line 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 the ability to convey attention to detail, 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 strategic terms related to reimbursement, risk‑sharing, quality performance metrics, dispute resolution, and termination rights
Coordinate closely 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 but not limited to ERISA, HIPAA, the No Surprises Act, CMS guidance, and New Jersey‑specific mandates
Ensure that contracts and payor strategies remain in compliance with all applicable laws and regulations
Advise on value‑based care models and alternative payment arrangements in accordance with fraud and abuse laws, including the federal Anti‑Kickback Statute, Stark Law, and state equivalents
Internal Legal Support and Business Strategy
Serve as a trusted advisor to system leadership, offering practical legal counsel that balances risk mitigation with business objectives
Proactively identify areas of legal risk and propose creative, legally compliant solutions that promote health system initiatives and strategic partnerships
Participate in cross‑functional teams focused on managed care strategy, payment innovation, and operational implementation of contractual terms
Administrative and Team Responsibilities
Maintain accurate documentation and tracking of all managed care agreements and associated legal files
Provide training and education 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 or contain a comprehensive listing of activities, duties or responsibilities that are required of the employee for this job. Duties, responsibilities and activities may change at any time with or without notice.
Benefits and Perks
Paid Time Off including Vacation, Holidays, and Sick Time
Retirement Plans
Medical and Prescription Drug Insurance
Dental and Vision Insurance
Disability and Life Insurance
Paid Parental Leave
Tuition Reimbursement
Student Loan Planning Support
Flexible Spending Accounts
Wellness Programs
Voluntary Benefits (e.g., Pet Insurance)
Community and Volunteer Opportunities
Discounts Through our Partners such as NJ Devils, NJ PAC, and Verizon
...and more!
RWJBarnabas Health is an Equal Opportunity Employer
#J-18808-Ljbffr