Payer Contracting, Policy and Regulatory Counsel

Central Vermont Medical Center

  • South Burlington, Vermont
  • 30+ days ago

    Highlights

    The position provides legal and strategic counsel regarding commercial payer agreements, Medicare Advantage contracts, Medicaid managed care arrangements, accountable care organization agreements, alternative payment models, value-based reimbursement programs, payer policies, regulatory compliance, contract disputes, and payment integrity matters. The role works closely with contracting, finance, population health, operations, revenue cycle, and executive leadership to ensure payer agreements advance organizational objectives related to financial performance, care transformation, quality outcomes, and population health management.

    Numbers & Facts

    LocationSouth Burlington, Vermont

    Description

    Building Name: UVMMC - 40 IDX Drive

    Location Address: 40 IDX Drive, South Burlington Vermont

    Regular

    Department: UVMHN – High Value Care

    Full Time

    Standard Hours: 40

    Biweekly Scheduled Hours:

    Shift: Day

    Primary Shift: -

    Weekend Needs: None

    Salary Range: Min $75.05 Mid $93.82 Max $112.58

    Recruiter: Chelsea Therrien

    The Payer Contracting, Policy & Regulatory Counsel serves as the lead legal, regulatory, and strategic advisor for payer contracting activities across the University of Vermont Health Network. As a key member of the integrated Payer Strategy and Contracting team, this role bridges traditional managed care contracting, value-based care contracting, payer policy analysis, regulatory interpretation, dispute resolution, and contract performance management.

    Unlike a traditional healthcare attorney focused solely on legal review, this position functions as a strategic business partner supporting payer negotiations, reimbursement strategy, payment innovation, and enterprise-wide value-based transformation. The role works closely with contracting, finance, population health, operations, revenue cycle, and executive leadership to ensure payer agreements advance organizational objectives related to financial performance, care transformation, quality outcomes, and population health management.
    The position provides legal and strategic counsel regarding commercial payer agreements, Medicare Advantage contracts, Medicaid managed care arrangements, accountable care organization agreements, alternative payment models, value-based reimbursement programs, payer policies, regulatory compliance, contract disputes, and payment integrity matters. The role serves as the organization's subject matter expert on payer contract interpretation, reimbursement policy, and regulatory developments impacting payer-provider relationships.

    Reports to: Vice President, Payer Strategy, Contracting

    Key relationships: High Value Care leadership / CFOs / Population Health / Revenue Cycle /Legal, Compliance /Finance / Clinical Leaders / payer representatives / outside counsel

    EDUCATION
    Required
    •    Juris Doctor (JD) from an accredited law school.
    •    Licensed and in good standing with the Vermont Bar or eligible for admission.
    Preferred

    Additional education or certification in: Healthcare Administration / Healthcare Finance / Compliance / Population Health / Value-Based Care

    EXPERIENCE
    Required
    •    Minimum of 7 years of progressively responsible experience in healthcare law, managed care contracting, or payer strategy.
    •    Significant experience negotiating and reviewing complex healthcare contracts.
    •    Demonstrated experience resolving payer disputes and reimbursement issues.
    •    Experience interpreting healthcare regulations and payer policy requirements.
    Preferred

    Experience within an integrated delivery network, academic medical center, health system, or payer organization

    Experience with: 

    • Commercial payer negotiations

    • Medicare Advantage contracting

    • Medicaid managed care programs

    • Value-based care arrangements

    • Accountable Care Organizations

    • Population health initiatives

    • Specialty pharmacy reimbursement

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