Global Medical Management Seeks Director of Negotiations/Legal Affairs

Global Medical Management is currently seeking a Director of Negotiations/Legal Affairs. Please see the following information:

General Summary:

Reports to COO. Works in collaboration with COO and senior management to enhance and implement procedures and special projects.  Responsible for cohesiveness, efficiency and quality assurance for negotiation services to clients. Works closely with VP of Healthcare Services,  Director of Claims, Account Directors/Managers to coordinate the development of efficiencies and procedures.

Primary Role & Responsibilities for Director of Negotiations: 

  • Maintains up to date written procedures for all claims and negotiation staff and processes. Sets up minimum requirements and corrective action plans for productivity and results.
  • Supervises daily work in the Negotiation department..
  • Ensures negotiation productivity on a daily basis, responsible for ensuring GMMI stays on tract with expectations.
  • Responsible for training of all negotiation staff.
  • Arranges, in coordination with the VP of Health Services, appropriate back-up staff to service all functions in his/her absence.
  • Reports complicated inquiries or complaints to the VP of Healthcare Services and COO and keeps them informed at all times.
  • Works closely with Senior Programmer in implementing and upgrading procedures in Visual Cost Care
  • Assures account adjustments are current and performed in accordance with GMMI policy.
  • Oversees and updates GMMI’s Fraud Detection Guidelines.
  • Coordinates and set internal guidelines for COB (Coordination of Benefits) as well as schedule staff COB training.
  • Knowledge of client product lines.
  • Performs other responsibilities and assignments as instructed by Management.

Primary Role & Responsibilities for Director of Legal Affairs:

  • Reviews and draft all contracts, leases, and agreements prior to entering into by or with GMMI and on behalf of GMMI or by any employee or third party.
  • Provides legal advice on any legal matters pertaining to GMMI.
  • Provides legal advice on any suits brought by or against GMMI.
  • Consults GMMI on any new laws, regulations or statues; whether state or federal.
  • Act as a legal consultant for GMMI in any legal matters, mediations, arbitrations, and hearings.
  • Support all Department Managers on legal matters affecting GMMI.
  • Provider General Legal Counsel
  • Draft letters and correspondences on behalf of GMMI. 

Minimum Knowledge, Skills and Abilities:

  • Knowledge and experience in healthcare and insurance field.  Account management and healthcare claims processing experience preferred.
  • If degrees in above fields are lacking then HIAA certification or active enrollment will be required starting 1/1/2001.
  • Proficient in GMMI philosophy on Provider, Marketing, Customer Service and Client Management.
  • Proficient in GMMI claims processing and reporting.
  • Excellent verbal and written communication skills  and ability to manage and prioritize multiple tasks.  Multilingual with excellent English language skills.
  • Excellent interpersonal skills necessary to interact positively with clients, providers and professional staff.  Must represent the organization in a professional and knowledgeable manner.
  • Computer skills essential to manage correspondence, database maintenance, spreadsheet analysis and for information entry / retrieval from the CostCare system.
  • Certified for Client Services.
  • Juris Doctor (J.D.) from the United States or equivalent law degree.  At a minimum will possess license to practice law in the State of Florida.

Interested candidates should send an email directly to Marlene M. Leon, MS, PHR, ISO/Quality Assurance Program Manager and HR Generalist, GMMI, Inc. In subject line have the candidate state – Dir. of Negotiation Position.  Salary is negotiable.