Legal Services Director

Role Overview

• Provides strategic management oversight in implementing, directing, and monitoring the Alliance’s Legal Services Department, which provides advice and counsel and performs enterprise risk management for Alliance operations
• Directs the Legal Services Department, acts as a leader and subject matter expert and provides direction and advice on legal and administrative contracting issues and overall business operations
• Manages and coordinates litigation and disputes related to Alliance operations
• Directs health plan administrative contracting, including maintenance of agreements and negotiation and re-negotiation of contracts in coordination with Alliance staff and external counsel
• Directs, manages, and supervises Legal Services Department staff

Requirements

• Juris Doctor degree from an accredited law school, admitted to and in good standing with the State Bar of California, and possession of an active license to practice law in California
• A minimum of seven years of experience as a practicing health care attorney performing research and analysis of legal, statutory, and regulatory information, which included a minimum of five years of management level experience and a minimum of three years of experience related to health plan operations; or an equivalent combination of education and experience may be qualifying
• Knowledge of health care laws
• Knowledge of Knox-Keene Health Care Service Plan Act and Regulations, Affordable Care Act, Health Insurance Portability and Accountability Act (HIPAA), Stark Law, and False Claims Act
• Knowledge of Medi-Cal, Medicaid, and Medicare rules, requirements, and regulations
• Knowledge of State regulatory agencies, such as DHCS, Centers for Medicare and Medicaid Services (CMS), and Department of Managed Health Care (DMHC)
• Knowledge of principles and practices of operational oversight and program and project management
• Knowledge of principles and practices of contract negotiation and review
• Ability to provide prudent legal recommendations and counsel to executive team members and Board members
• Ability to develop legal strategies and objectives based upon analysis of relevant information and resources, and make recommendations
• Ability to perform risk assessment, anticipate and respond to risks, and provide risk mitigation support
• Ability to provide leadership, facilitate meetings, and partner with and guide managers and employees in the resolution of issues
• Ability to act as a technical resource and explain complex laws, regulations, processes, and programs related to areas of responsibility
• Ability to review and assess overall department function, core work, goals, and structure, develop and implement short
• and long-term planning to achieve strategic plans, and complete an annual department assessment
• Ability to direct, manage, supervise, mentor, train and evaluate the work of staff

Benefits

• Medical, Dental and Vision Plans
• Ample Paid Time Off
• 12 Paid Holidays per year
• 401(a) Retirement Plan
• 457 Deferred Compensation Plan
• Robust Health and Wellness Program
• Onsite EV Charging Stations
• And many more