Senior Legal Counsel

Hpsj Mvhp; California (MO); Remote; USD 192,000 - 290,000; Full time

Job summary

A leading healthcare organization is seeking a Senior Legal Counsel to provide strategic legal advice and ensure regulatory compliance. The role involves managing legal risks, overseeing outside counsel, and collaborating with internal stakeholders to support business objectives in a complex legal environment.

Benefits

Health, dental, and vision insurance

Generous paid time off

Employer-Paid Disability Insurance

Education and training reimbursement

Qualifications

• Minimum of 8 years of healthcare legal experience.
• Experience with Medi-Cal and/or Medicare requirements.
• Experience providing legal counsel in a business setting.

Responsibilities

• Provide legal advice and guidance on compliance and regulatory issues.
• Manage and coordinate with outside counsel for litigation matters.
• Draft and review contracts between HPSJ and vendors.

Skills

Regulatory compliance

Risk management

Contract negotiation

Legal strategy development

Education

Juris Doctor degree from accredited law school

Job description

Health Plan of San Joaquin/Mountain Valley Health Plan provided pay range

This range is provided by Health Plan of San Joaquin/Mountain Valley Health Plan. Your actual pay will be based on your skills and experience — talk with your recruiter to learn more.

Base pay range

$192,000.00/yr - $290,000.00/yr

Direct message the job poster from Health Plan of San Joaquin/Mountain Valley Health Plan

Must reside in California - remote position.

What You Will Be Doing:

Under administrative supervision, the Senior Legal Counsel is responsible for providing and arranging for expert, strategic, and operational legal advice to HPSJ Executive Team and their designees. Responsible for statutory and regulatory compliance, new business development, employment, and other activities in a manner that ensures legal compliance limits risk exposure and supports external and internal requirements. Work is varied and complex and requires a high degree of discretion and independent judgment.

Legal Counsel, Contracts

Our Vision:

Continuously improve the health of our community.

Our Mission:

We provide healthcare value and advance wellness through community partnerships.

Essential Functions:

• Facilitates HPSJ’s legal activities by providing counsel and guidance on legal issues and on the legal implications on matter affecting HPSJ.
• Provides expert advice and works collaboratively with business owners to determine tasks and solutions on a variety of matters including regulatory compliance, contracts, risk management and insurance, litigation, governance and corporate transactions to ensure that the health plan is in compliance with all applicable laws and procedures.
• Manages and coordinates with outside counsel for litigation and regulatory actions filed against or on behalf of HPSJ.
• Oversee the management and evaluation of all outside counsel.
• Recommends, develops and defines the health plan’s policies and procedures.
• Provides guidance on the legal impact of newly enacted legislation, regulations, and changes in government agency requirements, business decisions, or processes that impact the health plan in the administration of its programs.
• Drafts, reviews, and provides counsel on contracts HPSJ enters into with health care providers and administrative services vendors.
• Evaluates, plans for and remediates enterprise risk related matters as issues and initiatives arise.
• Researches, analyzes, interprets and provides counsel on emerging and current laws and regulations, including those related to privacy, security, Medi-Cal/Medicaid and Medicare.
• Processes resolutions and executes major legal action regarding the HPSJ’s public entity status as it relates to jurisdiction, function, procedures, operations and responsibilities.
• Develops and maintains relationships with internal and external stakeholders, including state regulators.
• Identifies and implements of process improvement strategies, in collaboration with internal stakeholders.
• Creates and maintains appropriate and required data, records, reports and other documentation according to internal and external requirements.
• Manages copyrights and trademarks.

What You Bring:

Knowledge, Skills, Abilities and Competencies

Required

• Ability to provide prudent legal decision recommendations.
• In-depth knowledge of the California and Federal healthcare landscape - Medi-Cal Managed Care and Medicare D-SNP.
• In-depth knowledge and understanding of applicable California and Federal laws and regulations which govern HPSJ, including California and Federal health laws, CCR & CFR, litigations, labor law and provider contracting.
• Ability to anticipate and respond effectively to legal issues and risks.
• Ability to develop legal strategies and objectives.
• Strong assessment and analytical skills, including the ability to synthesize, distill concepts, draw conclusions and identify implications.
• Financial acumen: Interprets and applies understanding of key financial indicators to make better business decisions.
• Strategic mindset: Sees ahead to future possibilities and translates them into breakthrough strategies.
• Drives results: Consistently achieves results, even under tough circumstances.
• Manages complexity: Makes sense of complex, high quantity, and sometimes contradictory information to effectively solve problems.
• Decision quality: Makes good and timely decisions that keep the organization moving forward.
• Builds networks: Effectively builds formal and informal relationship networks inside and outside of the organization.
• Resourcefulness: Secures and deploys resources effectively and efficiently; organizes people and resources to solve problems and identify opportunities.
• Plans and aligns: Plans and prioritizes work for self and others to meet commitments aligned with organizational goals.
• Ensures accountability: Holds self and others accountable to meet commitments.
• Persuades: Uses compelling arguments to gain the support and commitment of others.
• Manages ambiguity: Operates effectively, even when things are not certain, or the way forward is not clear.
• Organizational savvy: Maneuvers comfortably through complex policy, process and people- related organizational dynamics.
• Collaborates: Builds partnerships and works collaboratively with others to meet shared objectives.
• Creates a climate where people are motivated to do their best to help the organization achieve its objectives.
• Handles conflict situations effectively, with a minimum amount of noise.
• Recognizes the value that different perspectives and cultures bring to an organization.
• Demonstrates a high degree of professional ethics and integrity.
• Gains the confidence and trust of others through honesty, integrity and authenticity.
• Strong presentation skills, including the ability to tailor presentations to a specific audience, and address and interact with large groups.
• Strong interpersonal skills with the ability to initiate establish and maintain effective working relationships with diverse individuals both inside and outside of HPSJ.
• Strong oral and written communication skills with the ability to communicate professionally, effectively and persuasively with diverse individuals and groups inside and outside of HPSJ; includes the ability to effectively explain complex information.
• Demonstrated ability to articulate and support HPSJ’s vision, mission, values and strategy, integrate into management practices, and foster their manifestation among staff.
• Intermediate skills in MS Office suite, including Outlook and PowerPoint.
• Ability to speak and be understood in English.
• Ability to handle confidential information with appropriate discretion.

What You Have:

Education and Experience

Required

• Juris Doctor degree from accredited law school; and
• At least eight years of healthcare legal experience; and
• Experience with Medi-Cal and/or Medicare managed care program requirements.
• Experience working closely with internal and external leadership.
• Experience providing legal counsel in a business environment.
• At least four years of supervisory experience.

Preferred

• Experience as an in-house counsel and/or counsel for a public agency.
• Experience working with regulators and with outside counsel.

Licenses, Certifications

Current state bar license to practice law in the State of California.

What You Will Get:

• Robust and affordable health/dental/vision with choices in providers
• Generous paid time off (accrue up to 3 weeks of PTO, 4 paid floating holidays including employee’s birthday, and 9 paid holidays)
• CalPERS retirement pension program, automatic employer-paid retirements contributions, in addition to voluntary defined contribution plan
• Two flexible spending accounts (FSAs)
• Employer-Paid Term Life and AD&D Insurance
• Employer-Paid Disability Insurance
• Employer-Paid Life Assistance Program
• Health Advocacy
• Supplemental medical, legal, identity theft protection
• Access to exclusive discount mall
• Education and training reimbursement in addition to employer-paid elective learning courses.
• A chance to work for an organization that is mission-driven – our members and community are at the core of everything we do.
• A shorter commute – if you’re commuting from the Central Valley to the Bay Area.
• Visibility and variety – you have a chance to work with people at all levels of the organization, and work on diverse projects.

Seniority level

• Seniority level

  Director

Employment type

• Employment type

  Full-time

Job function

• Job function

  Legal

• Industries

  Insurance

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