Legal Counsel

Job Title

Legal Counsel

Location

Remote/Nationwide, USA

Additional Location(s)

Employee Type

Employee

Working Hours Per Week

40

SUMMARY
Oversee the compliance program and legal affairs of Graham Healthcare Group (GHG). Ensure that the Board of Directors, management, and employees achieve consistently high levels of compliance with all laws, regulations, accrediting bodies (ACHC), and the organizations own Code of Conduct while supporting the growth of GHG. Conduct audits to monitor compliance. Serve as a key legal advisor to management on matters such as complex business transactions, litigation, and negotiation of critical contracts. Oversee all aspects of contract management, corporate governance, risk management, and regulatory filing management.
ESSENTIAL DUTIES AND RESPONSIBILITIES
include the following. Other duties may be assigned as necessary.
GENERAL
Directly manage the Compliance and Legal teams
Establish KPI measurables for monitoring results versus objectives
Develop and engage Legal and Compliance team members by creating a motivating work environment that recognizes and rewards strong performance
COMPLIANCE
Report to the Board of Directors, Executive Leadership and Compliance Committee(s) of GHGs hospital joint venture partners on compliance-related matters, initiatives and improvements/changes in the overall compliance program at least quarterly
Maintain control of all corporate policies, procedures, and practices for the general operation of GHG and its related activities to prevent illegal, unethical, or improper conduct
Oversee periodic reviews and updates of GHGs corporate policies and Code of Conduct to ensure continuing currency and relevance in providing guidance to management and employees
Collaborate with other departments to direct compliance issues to appropriate existing channels for investigation and resolution
Respond to alleged violations of rules, regulations, policies, procedures, and codes of conduct by evaluating and/or recommending the initiation of investigative procedures
Develop and oversee a system for uniform handling of such violations
Collaborates with GHG leadership to conduct an annual compliance risk assessment and internal audit plan based on Office of Inspector General recommendations
Identify potential areas of compliance vulnerability and risk, develop/implements corrective action plans for the resolution of problematic issues, and provide general guidance to GHG management and employees on how to avoid or deal with similar situations in the future through the execution of routine internal audits
Ensure proper reporting of violations or potential violations to duly authorized enforcement agencies (i.e. Office of Civil Rights) as appropriate and/or required
Establish and provide direction and management of GHGs compliance hotline. Monitor a log/tracking system for all confidential disclosures through the hotline
Institute and maintain an effective compliance communication and training program for GHG, including promoting (a) use of the compliance hotline, (b) heightened awareness of GHGs policies, procedures, and code of conduct, and (c) understanding of new and existing compliance issues and related policies and procedures
Works with GHG Human Resources, Education, and others as appropriate to develop an effective compliance training program, including appropriate introductory training for new employees, as well as ongoing training for all employees and managers
Provide education and training about actual, proposed, or pending legislation and regulations that affect operations, compliance, or accreditation
Partner with the VP of Revenue Cycle on maintaining and communicating knowledge of payor claim submission guidelines and coverage requirements through routine education of employees on such guidelines and requirements
Oversee the resolution and fulfillment of ADR requests and propose policy changes within Revenue Cycle and Operations as a result of Audit denials
Monitor all OASIS and HIS submissions
Keep executive leadership apprised of newly identified potential compliance issues and ongoing investigations
Serve as a resource and consultant to agency administrators and operations leadership on ACHC standard survey prep
Oversee and direct GHGs Privacy and Safety program
Collaborate with the Privacy Officer and IT Security Manager on the investigation and/or resolution of all privacy-related complaints
LEGAL
Prepare, negotiate, and/or review drafts of various contractual documents including but not limited to subcontract agreements, master service agreements, staffing agreements, non-compete agreements, vendor contracts, medical director agreements, leases, licenses, purchase and sale agreements, and business associate agreements
Review all existing contracts for business or legal risks and suggest changes or facilitate re-negotiations, as indicated, on behalf of the Company
Oversee all company contracts, contract maintenance, and contract renewals
Defend the company against lawsuit claims
Draft and negotiate purchase agreements related to M&A and Joint Venture transactions
Prepare and file documents with state and federal agencies, including Articles of Incorporation, Assumed Names, Certificates of Good Standing, Patents, Copyrights, and Trademarks. Participate in document compilation in corporate transactions
Interpret and advise all levels of management on legal matters, legal issues, governmental regulations, and policies
Advise on employment-related legal activities such as policies, employment claims, litigation, and general employment law issues
Engage with and maintain positive working relationship with outside counsel agencies
Comply with Graham Healthcare Groups Core Values and Core Competencies
QUALIFICATION REQUIREMENTS
To perform this job successfully, an individual must be able to perform each essential duty satisfactorily. The requirements listed below are representative of the knowledge, skill, and/or ability required. Reasonable accommodations may be made to enable individuals with disabilities to perform the essential functions.
Degree (JD) from an ABA accredited law school
Active Bar memberships and license to practice law in the state of Michigan
Preferred BS degree in Nursing, Masters desired with a valid RN state license
A minimum of ten years of experience in a health care organization, with home health and hospice experience preferred
A minimum of ten years of experience as an attorney in a law firm or corporate environment and/or compliance officer
Significant exposure to ACHC, Medicare and Medicaid reimbursement and regulations, Stark Law, Anti-Kick Back Laws and fraud and abuse laws
Exposure or experience with employment law and regulations such as ACA, ERISA, FLSA, FMLA, and EEO
Experience with planning and executing risk assessments and internal audits
CHC, CHPC, and/or CPCO certification
Working knowledge of Homecare Homebase EMR preferred
A high degree of credibility, independence, integrity, and trustworthiness
Strong communication and leadership skills are essential
Sound business judgement and is supportive of GHGs mission and objectives
Able to command respect of Senior Management team, board-level committees, and other members of the Compliance and Legal team
Able to develop partnerships, teamwork, and good working relationships. Maintain an open management style
Understand the complexities of a large organization. Involve others appropriately in consultations and decisions
Understand the legal regulatory framework of the organization
Exhibit good presentation skills with large and small audiences
Able to operate successfully in a constantly changing, fast-paced environment
Demonstrated initiative, self-motivation, practical learning skills, enthusiasm, and ability to complete multiple tasks in a timely and acute manner
Up-to-date working knowledge of federal, state, and local regulations impacting the home health and hospice industry; HIPAA, ACHC standards; Medicare and Medicaid Conditions of Participation
Travel to GHG locations (MI, IL, and PA) periodically for audit activities, presentations, education or investigations, as needed
Education and/or Experience
Legal Degree (JD) from an ABA accredited law school
Active Bar memberships and license to practice law in the state of Michigan
Preferred BS degree in Nursing, Masters desired with a valid RN state license
A minimum of ten years experience in a Health Care Organization, Home Health and Hospice specific experience preferred.
A minimum of ten years experience as an attorney in a law firm or corporate environment and/or compliance officer.
Significant exposure to ACHC, Medicare and Medicaid reimbursement and regulations, Stark Law, Anti-Kick Back Laws and Fraud and Abuse Laws.
Exposure or experience with employment law and regulations such as ACA, ERISA, FLSA, FMLA, and EEO.
Experience with planning and executing risk assessments and internal audits.
CHC, CHPC, and/or CPCO certification.
Working knowledge of Homecare Homebase EMR preferred.
CERTIFICATES, LICENSES, REGISTRATIONS
Must have and maintain in good standing professional license, certificate, or registration, as applicable.
PHYSICAL DEMANDS
The physical demands described here are representative of those that must be met by an employee to successfully perform the essential functions of this job. Reasonable accommodations may be made to enable individuals with disabilities to perform the essential functions.
While performing the duties of this job, the employee is regularly required to talk or hear. The employee regularly is required to stand, walk, sit, climb stairs, use hand to finger, handle or feel objects, tools, or controls; and reach with hands and arms.
The employee frequently lifts and/or moves up to 20 pounds. Specific vision abilities required by this job include close vision and the ability to adjust focus.
WORK ENVIRONMENT
The work environment characteristics described here are representative of those an employee encounters while performing the essential functions of this job. Reasonable accommodations may be made to enable individuals with disabilities to perform the essential functions.
This job generally operates in a clerical office setting. This role routinely uses standard office equipment such as computers, phones, photocopiers, filing cabinets, and fax machines. While performing the duties of this position, the employee may travel by automobile and be exposed to changing weather conditions.
COMMENTS
This description is intended to describe the essential job functions, the general supplemental functions, and the essential requirements for the performance of this job. It is not an exhaustive list of all duties, responsibilities, and requirements of a person so classified. Other functions may be assigned, and management retains the right to add or change the duties at any time.

NOTICE:

• Successful completion of a drug screen prior to employment is part of our background process, which includes medical and recreational marijuana.
• By supplying your phone number, you agree to receive communication via phone or text.
• By submitting your application, you are confirming that you are legally authorized to work in the United States.

Graham Healthcare Group is an Equal Opportunity Employer