STAFF ATTORNEY I-ABQ
Location: Albuquerque, New Mexico
Description: Presbyterian Healthcare Services is employing STAFF ATTORNEY I-ABQ right now, this position will be dwelled in New Mexico. More details about this position opportunity please give attention to these descriptions. Minimum Skills/Requirements
Juris Doctor degree; New Mexico license to Practice Law required; must be a member in good standing of the New Mexico State Bar. Two or more yea! rs experience in practicing insurance or regulatory law or Medicaid or comparable experience.
Requires detailed knowledge of local, state and federal regulations and law involving managed care organizations in terms of what and how work is to be done as well as why it is done.
Primary Job Functions
Provide in-house counsel, compliance guidance, advice and services to Presbyterian Health Plan, Inc. regarding healthcare laws and regulations, appeals and grievances, contracting, credentialing and policies and procedures related to the New Mexico’s Managed Medicaid Program (also known as Centennial Care).
Provide advice regarding the interpretation of the State of New Mexico Medicaid Program and associated regulations.
Provide advice regarding the interpretation of Medicare and Medicaid laws and regulations, including specifically those related to Medicaid Managed Care.
Provide legal support in the negotiation, drafting an! d interpretation of provider agreements, member handbooks and ! other participation agreements.
Provide legal support in the negotiation, drafting and interpretation of contracts to which PHP is a party.
Provide legal support for member and provider appeal and grievance proceedings, including fair hearings and inquiries before HSD.
Provide legal support for quality management and peer review activities.
Periodic court appearances to support Centennial Care activities.
Provide Centennial Care policy and procedure review, as required.
Provide education to the health plan.
Provide backup coverage for the Health Plan Staff Attorneys, or when appropriate, those assigned to the Risk Management and Delivery System functions.
Performs other functions as required.
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If you were eligible to this position, please send us your resume, with salary requirements and a resume to Presbyterian Healthcare Services.
Interested on this position, just click on the Apply button, you will be redirected to the official website
This position will be started on: Tue, 16 Jul 2013 21:30:22 GMT
Apply STAFF ATTORNEY I-ABQ Here