GENERAL PURPOSE:Supporting the goals and expectations established for the Office of Counsel, the Senior Counsel identifies, analyzes and provides legal guidance and services on complex health care regulatory and corporate matters relevant to the University of Rochester Medical Center (Medical Center) and its health care affiliates, including hospitals, long term care facilities, home health agencies, providers, and independent and assisted living communities. This includes, but is not limited to: fraud and abuse, billing compliance, corporate transactions, physician employment and compensation, telemedicine, graduate medical education and other legal matters. Manages disputes, risks and projects related to regulatory compliance and legal transactions. Identifies regulatory risks and exposures to the Deputy General Counsel for Health Sciences and other key stakeholders, and recommends appropriate actions.SPECIFIC RESPONSIBILITIES:
Consistent with the values and strategic priorities established by the General Counsel and the Deputy General Counsel for Health Sciences, researches, analyzes, and provides regulatory compliance advice on the Fraud and Abuse Laws, including, but not limited to, the Anti-Kickback Statute, the Physician Self-Referral Law, the False Claims Act, Civil Monetary Penalties, and Medicare and Medicaid billing regulations (including CMS, Medicare Advantage and New York State Medicaid). Manage disputes, risks and projects related to regulatory compliance and legal transactions.
Using expert knowledge of regulatory compliance laws, advises and provides guidance to stakeholders including, but not limited to the Office of Integrity and Compliance on relevant reimbursement and billing issues and requirements (including CMS, Medicare Advantage, and New York State Medicaid). Stays abreast of Medicare and Medicaid billing requirements.
Collaborates closely with the Medical Center’s Office of Integrity and Compliance, providing analysis and legal advice to senior leadership on billing compliance and other regulatory matters. Advises on and drafts self-disclosures, audit responses, and legal challenges to payor overpayment and adverse payment determinations with limited supervision of Deputy General Counsel for Health Sciences. Coordinates with regulatory agencies and responds to governmental regulatory initiatives. Identifies legal issues and exposures to management and recommends appropriate resolutions or future actions.
Supports complex corporate transactions, including acquisition of physician practices and affiliations with hospitals, health systems, and health care providers. In the context of such transactions, conducts due diligence, drafts and negotiates definitive agreements, and addresses all relevant issues such as Stark and Anti-Kickback, real estate, antitrust, billing compliance, contracts, equipment lease/purchase, medical records custody, and faculty/staff hiring and employment.
Reviews, drafts and negotiates contracts and provides legal advice related to hospital and physician relationships, as well as with vendors and consultants, including faculty employment agreements, professional service agreements, telehealth agreements, student and graduate trainee clinical affiliation agreements, laboratory services agreements, confidentiality agreements, data use and business associate agreements. Recommends contract content and updates, as appropriate.
Advises and occasionally serves on University and affiliate committees.
With approval of the General Counsel or Deputy General Counsel for Health Sciences, oversees outside legal counsel working on University or affiliate legal issues or legal disputes and responds independently to outside counsel negotiating with or bringing disputes against the University, its affiliates and/or their personnel.
Other duties as assignedREQUIREMENTS :
Juris Doctorate required.
10 years of relevant legal experience required;
or equivalent combination of education and experience required.
Knowledge of healthcare regulatory compliance and legal experience preferred.
General familiarity with the following areas preferred:
Medicare and Medicaid billing regulations (including CMS, Medicare Advantage and New York State Medicaid);
Fair market value and commercially reasonable concepts;
Student affairs (FERPA; Title IX, academic and non-academic discipline; disability accommodations and ADA compliance; local, state and federal civil rights laws affecting admissions, financial aid and programs; athletics; study abroad)
Faculty affairs (tenure, academic freedom, grievances)
Copyright and intellectual property
General liability/risk management
Charitable giving
Specialized knowledge in one or more fields of law relevant to the needs of the University required;
Knowledge of specialty health care topics relevant to the needs of the Medical Center, sufficient to identify legal issues and provide advice and guidance to leadership, in areas including, but not limited to, global health, telehealth, provider licensure and scope of practice, medical staff credentialing and privileging, tax-exempt organization rules and regulations, and/or graduate medical education preferred.
Ability to successfully plan for and lead complex projects within deadlines required.
Experience working in a university, college, or with an organization that includes an academic medical center preferred.
Excellent communication skills, including demonstrated ability and judgment in the timely, effective transmission of information to stake holders, including the General Counsel. Strong writing skills required.
Strong attention to detail required.
Ability to prioritize work independently and complete projects in a timely manner required.
Knowledge in areas of the law directly impacting governing boards and senior executives such as corporate governance and fiduciary duties, ethics, and legal compliance, and strategic transactions preferred.
New York State bar admission or eligibility for registration in New York to work for the University as in-house counsel, with commitment to become licensed in NYS required.
NOTE: This document describes typical duties and responsibilities and is not intended to limit management from assigning other work as required.The University of Rochester is committed to fostering, cultivating, and preserving a culture of equity, diversity, and inclusion to advance the University’s mission to Learn, Discover, Heal, Create – and Make the World Ever Better. In support of our values and those of our society, the University is committed to not discriminating on the basis of age, color, disability, ethnicity, gender identity or expression, genetic information, marital status, military/veteran status, national origin, race, religion/creed, sex, sexual orientation, citizenship status, or any other status protected by law. This commitment extends to the administration of our policies, admissions, employment, access, and recruitment of candidates from underrepresented populations, veterans, and persons with disabilities consistent with these values and government contractor Affirmative Action obligations.How To ApplyAll applicants must apply online.EOE Minorities/Females/Protected Veterans/DisabledPay RangePay Range: $178,474 - $285,558 AnnuallyThe referenced pay range represents the minimum and maximum compensation for this job. Individual annual salaries/hourly rates will be set within the job’s compensation range, and will be determined by considering factors including, but not limited to, market data, education, experience, qualifications, expertise of the individual, and internal equity considerations.Apply for Job
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Location: Health Sciences
Full/Part Time: Full-Time
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