Caroline Guerrero

About Caroline Guerrero

Experienced in-house healthcare regulatory and operations attorney.

Experience

1. Associate General Counsel - Optum

   Optum

   Jun 2022 — Present

   Support the Optum Care Delivery businesses on contract negotiations, including value-based reimbursement/payor arrangements, health plan contracting, network and provider contracting (including provider compensation and incentives), employment agreements, facility agreements, vendor agreements, electronic medical record agreements (EMR), management services organization agreements, MSAs, and BAAs. Support risk bearing organizations, licensed Knox-Keene entities (DMHC regulatory filings), medical groups and IPAs. Advise senior business leaders on relevant federal and state laws, HIPAA, CMS regulations, anti-kickback laws, the False Claims Act, Corporate Practice of Medicine (CPOM), Medicaid, Medicare, Knox-Keene Act, and other health care laws. Advise the business teams on potential and existing disputes. Support UM, credentialing, claims, NCQA accreditation and other care delivery operations. Support contract implementation, mergers and acquisitions, real estate leases, and on-going operational compliance, including proactive risk identification and mitigation, and issue resolution. Provide legal guidance on both equity and asset M&A deals. Assist businesses in developing measures to improve governance, integration, and implementation. Work closely with business team, Regulatory, Compliance, Privacy, Litigation and Employment, Corporate Governance, and other key stakeholders to identify and reduce known and potential regulatory, legal and business risks.

Education

• University of Arizona

  B.A. Political Science; B.A. Classical Civilizations; Magna Cum Laude

  2009 — 2012

• Salpointe Catholic High School

  High School Diploma

  2005 — 2009

• University of Notre Dame

  Doctor of Law (J.D.)