Chief Legal Counsel providing expert legal guidance on Medicare and Medicaid regulatory compliance. Coordinating investigations and ensuring compliance with health care laws and regulations in the United States.
Responsibilities
Provide legal counsel on Medicare and Medicaid regulatory compliance
Review and interpret federal and state regulations applicable to agency operations
Support the development and implementation of administrative actions including payment suspensions, revocations, and referrals
Coordinate with CMS, law enforcement, and other stakeholders on legal matters related to fraud, waste, and abuse
Ensure compliance with CMS policies, HIPAA, and other applicable laws
Draft and review legal documents, memoranda, and reports
Support contract compliance and risk mitigation strategies
Collaborate with internal teams and external stakeholders to ensure legal integrity of operations
Maintain up-to-date knowledge of healthcare law and policy changes
Requirements
Must be a licensed attorney in good standing
Minimum 3 years of experience applying Medicare and Medicaid regulations
Eligible to complete the HHS background verification process at the Public Trust clearance level
US Citizenship is required
Experience supporting CMS contracts or working with federal health care programs
Experience with the CMS fraud workflow and processes for healthcare fraud investigations
Demonstrated experience in health care law, regulatory compliance, or program integrity
Familiarity with fraud detection, investigations, and administrative enforcement processes
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