Associate Counsel III Senior Director Health Care Legal Services

Job Summary

The Associate Counsel III Senior Director Health Legal Services is responsible for diverse legal activities.  This position provides analysis of health care regulatory matters and assisting with the development and review of legislative bills and administrative regulations.  The Associate Counsel III reviews policies and procedures to ensure compliance with all legal authorities and confers with outside attorneys, state or county officials, and other interested parties.  This position supports L.A. Care’s product lines and operations by providing substantive legal counseling on complex matters. This position provides non-supervisory guidance for staff counsel, paralegals, support personnel. This position reports directly to the Associate General Counsel, should the Associate General Counsel position be vacant, this position reports to the General Counsel.

The Associate Counsel III Senior Director Health Care Legal Services collaborates on the improvement of communication between the department and key stakeholders to define opportunities, identify and prioritize programs and projects based on predefined criteria (e.g. return on investment, productivity, compliance). Provides expert advice to various teams, including program and product development, marketing, and customer service, on various relevant topics.

Duties

Participates as a senior attorney member of the Legal Department’s Health Care Legal Services Unit (HCLS) supporting L.A. Care in a matrix management organizational structure by providing needed legal advice and counsel on the most complex and sensitive matters regarding various laws applicable to health care service plans, with an emphasis on California law.

Provides substantive counseling on complex provider contracting and other legal matters.

Manages outside counsel in connection with organization’s healthcare activities.

Provides significant effort for HCLS’s support of the provider and payer efforts.

Provides non-supervisory guidance for other HCLS staff.                             

Interfaces directly with L.A. Care leadership and acting on behalf of the Associate General Counsel as needed.

Provides expert advice to various business units on relevant topics within the organizational standards, national and statewide compliance.

Evaluates the effectiveness of program implementation, and provides guidance and recommend process improvement.

Communicates strategic planning outcomes and the agreed upon priorities across the organization, to include ongoing progress of priorities.

Duties Continued

Leads efforts to allow the company to mitigate risk such as regulatory or competitive risks through innovative business ideas and solutions.

Responsible for communicating decisions, priorities and relevant project information to appropriate levels of staff regarding business unit requests and projects and initiatives.

Responsible for sharing solution roadmaps and enterprise level strategies to drive efficiencies across the organization and with customers. Collaborates with management to develop annual budgets for respective business areas. 

Provides support in delivering programs that meet the compliance needs of the organization

Performs other duties as assigned.

Education Required

Education Preferred

Experience

Required:

Minimum of 6 years of experience as a practicing licensed attorney and has acted as senior counsel on legal projects and matters.

Experience in an HMO or as counsel to a health system, hospital, government unit, or a health care law firm practice.

Experience and knowledge of health care law.

Experience in supporting complex provider contracting activities including drafting and reviewing contracts, providing strategic advice regarding negotiations and operations on complex and sensitive matters.

Preferred: 

Substantial experience in Medi-Cal or Medicaid and Knox-Keene Act.

Experience in Medicare, commercial lines of business and Health Insurance Portability and Accountability Act (HIPAA).

Supervisorial experience.

Experience in and knowledge of public entity laws including the Brown Act, Political Reform Act and Public Records Act.

Skills

Required:

Excellent interpersonal oral and written communication skills to facilitate open and clear dialogue with payers, regulators, providers, internal clients, contractors, vendors and L.A. Care leadership.

Licenses/Certifications Required

Licenses/Certifications Preferred

Required Training

Physical Requirements

Additional Information

Required:

Successfully passed California bar exam and maintains valid license/ certificate and be in good standing.