Healthcare Attorney (Pharmacy / Provider Contracting)

With more than 7,000 employees, we are the largest health insurance company in Michigan. We offer an exciting work environment with a diverse group of employees. Our goal is to make health insurance easier for our members. We want to transform the industry and become a resource that people can trust.

Detroit, MI

Blue Cross Blue Shield of Michigan

When you think of <a href="" target="_blank" rel="noopener noreferrer">Blue Cross Blue Shield of Michigan</a> for health insurance, you can know you&rsquo;re getting much more. We're a company founded on a tradition of affordable, quality health care for everyone, improving the present and investing in the future.<br /><br />We offer:<br />Plans for employers and individuals that meet today&rsquo;s needs, budgets and lifestyle<br />The largest network of doctors and hospitals in the state<br />Lower health care costs Higher quality health care<br />Award-winning diversity practices<br />Grants and programs that promote better health throughout Michigan<br /><strong><br />Mission:&nbsp;</strong>We commit to being our members&rsquo; trusted partner by providing affordable, innovative products that improve their care and health.<br /><br /><a href="" target="_blank" rel="noopener noreferrer"><strong>Click here</strong></a> to learn more about our commitment to our Social Mission, view company updates and reviews, and view our awards &amp; accolades.<br /><br />Learn more about your options as an external candidate. <a href="" target="_blank" rel="noopener noreferrer">Click here</a> to view open positions.

keywords: professional,legal,analysis,administration,publishing,department requirements,education,knowledge,experience,skills


Competitive Total Compensation Package

Overview: Responsible for applying legal principles, knowledge and skills based on legal experience.
Responsibilities: <div id="requisitionDescriptionInterface.ID1510.row1" class="contentlinepanel" title=""> <div><span style="font-size: small;">Responsible for applying knowledge, skills, and legal experience in handling matters in the areas of commercial pharmacy and Medicare Part D benefits and compliance, and pharmacy and provider contracting and network management. Independently evaluates and applies legal themes procedures and criteria using judgment in solving cases or issues. Provide guidance to Associate Attorneys, interns, externs and paralegals as needed. Accomplishes assigned results for conventional cases or for significant phases of larger, complex cases. Draft well-reasoned opinions and sophisticated contracts. Performs other related duties as assigned.</span></div> </div> <br /> <ul> <li>Independently evaluates and selects legal techniques, procedures and criteria using judgment in solving cases in the legal realm.&nbsp;</li> <li>Drafts complex legal documentation and works on moderately complex cases.&nbsp;</li> <li>Accomplishes assigned results for conventional cases or for significant phases of larger, complex cases.</li> <li>Performs a broad range of work that is conventional and for which there are set precedents.&nbsp;</li> <li>Assists with appearances in courts and administrative agencies.&nbsp;</li> <li>Other duties may be assigned.</li> </ul>
Requirements: <ul> <li>Juris Doctor Degree in law required.</li> <li>Seven (7) years of legal experience preferred</li> <li>Knowledge of court and agency procedures.</li> <li>Demonstrated knowledge of leadership concepts.</li> <li>Must have good clarity of thought, discretion and judgment ability.</li> <li>Must be able to develop rapport with client and to engender confidence with the client and in their own professional competence and judgement.</li> <li>Highly developed sense of ethics and integrity.</li> <li>Good analytical, negotiation, organizational, presentation, verbal and written communication skills.</li> <li>Capable to work effectively in a team environment.</li> <li>Ability to read, analyze and interpret statutes, general business and legal periodicals, professional journals, technical</li> <li>procedures and governmental regulations.</li> <li>Ability to draft contracts, opinions, reports, business correspondence, and procedures.</li> <li>Qualified to effectively present information and respond to questions from regulators, clients, customers and the public.</li> <li>Other related skills and/or abilities may be required to perform this job.</li> <li>Must be a member in good standing with the Michigan State Bar Association.</li> </ul> <p><strong>Departmental Requirements:</strong></p> <ul> <li>Experience with Medicare Advantage Part D administration and compliance matters and interpretation of Part D&nbsp;regulations and guidance.</li> <li>Experience with pharmacy benefit design and operations; understanding of state pharmacy and insurance laws.</li> <li>Experience with administrative hearings/appeals for facility audit disputes and member appeals.</li> <li>Experience with general contract drafting/interpretation.</li> <li>Experience with drafting and negotiating various pharmacy-related agreements, such as benefit management and pharmacy network agreements; and pharmacy services agreements; pharmaceutical manufacturer rebate agreements; and medication therapy management agreements.</li> <li>Experience drafting and negotiating various provider contracts, including contracts with professionals, facilities, and network leases.</li> <li>Experience with Medicare Advantage Part C a plus.</li> <li>Experience with Dental or Vision networks a plus.</li> </ul>