Sr. Corporate Counsel, Payor Contracting

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Position Summary:

Under the supervision of the Chief Legal Officer and Corporate Secretary, the Sr. Corporate Counsel of Payor Contracting is responsible for supporting the end-to-end contract negotiation, ensuring that agilon’s payor contracts meet internal and external requirements, and assist with contract disputes to effectively support agilon and our physician group partners’ achievement of overall growth and profitability goals and to minimize risk. Develops and revises the contract template language to meet the needs of agilon and participates in development of overall market payor strategy for all markets.

Essential Job Functions:

• Partners with SVP of Payor Contracting, SVP of Strategy and Market Presidents to develop strategies and work plans to increase profitable membership in Medicare Advantage agreements. 

• Drafts, updates and maintain payor contract templates

• Provide targeted support and contracting expertise to engage in contract negotiations with new and existing payors that meet financial goals and protects Company’s interests and consistent with any national payor strategy

• Negotiate terms and conditions in accordance with Company goals and policy.  Ensure that payor contracts are compliant with legal requirements, contract specifications and government regulations.

• Collaborates with the VP, Contract Analysis to support the development of contract financial models, ensure negotiation of financial terms that meet Company goals, and assures the final contract terms are consistent with the final approved model.           

• Actively monitor healthcare, regulatory and legal environment/developments and advise on all language for contracts

• Provide legal support for business's preparation for JOCs and relevant outcomes

• Attorney to attorney engagement with the payor’s attorney for informal discussions, contract negotiation escalations, disputes, and resolutions

• Collaborate with the payor contracting team and strategy team to monitor contract timing requirements and deadlines for CMS bid submissions, contract reconciliations, data reports and dispute notices      

Required Qualifications:

Minimum Experience

• 5 – 10 years’ experience negotiating Medicare Advantage payor risk agreements in a law firm or in-house setting

• Medicare Part D negotiating experience preferred.

• Experience managing external business relationships at senior and executive levels. 

• Demonstrated ability to draft and negotiate agreements, provide clear advice under complex situations, gain trust and build relationships among various stakeholders.

• Knowledge of Value-Based Care, Medicare Advantage Organizations, Risk-Bearing Entities, Part D Regulations, and DOFR allocations

• Ability to exercise leadership, self-initiative, independence, sound judgment and work pro-actively, with minimal guidance and supervision.

• Ability to identify and articulate legal and business risks and support balanced business decision making.

• Ability to function effectively in a matrix organization, and to work within inter-departmental teams.

Education/Licensure:

• Juris Doctor degree

• Licensed to practice law in at least 1 jurisdiction.

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Salary range shown is a guideline. Individual compensation packages can vary based on factors unique to each candidate, such as skill set, experience, and qualifications.