Senior Counsel / Assistant Vice President, Legal Affairs, Managed Care Contracting

RWJBarnabas Health

  • West Orange, NJ
  • Permanent
  • Full-time
  • 2 months ago
Job Title: Senior CounselLocation: SBC CorporationDepartment Name: General Counsel OfficeReq #: 0000206244Status: SalariedShift: DayPay Range: $175,000.00 - $295,000.00 per yearPay Transparency:The above reflects the anticipated annual salary range for this position if hired to work in New Jersey.The compensation offered to the candidate selected for the position will depend on several factors, including the candidate's educational background, skills and professional experience.Assistant Vice President of Legal Affairs, Managed Care ContractingJob 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,Reports to:
  • 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.Additional Info:Benefits and Perks:At RWJBarnabas Health, our employees are at the heart of everything we do. Driven by our Total Wellbeing promise, our market-competitive offerings include comprehensive benefits and resources to support our employees’ physical, emotional, financial, personal, career, and community wellbeing. These benefits and resources include, but are not limited to:
  • 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!
Choosing RWJBarnabas Health!RWJBarnabas Health is the premier health care destination providing patient-centered, high-quality academic medicine in a compassionate and equitable manner, while delivering a best-in-class work experience to every member of the team. We honor and appreciate the privilege of creating and sustaining healthier communities, one person and one community at a time. As the leading academic health system in New Jersey, we advance innovative strategies in high-quality patient care, education, and research to address both the clinical and social determinants of health.RWJBarnabas Health aims to truly make a unique impact in local communities throughout New Jersey. From vastly improving the health of local residents to creating educational and career opportunities, this combination greatly benefits the state. We understand the growing and evolving needs of residents in New Jersey—whether that be enhancing the coordination for treating complex health conditions or improving community health through local programs and education.

RWJBarnabas Health