Assistant General Counsel - Clinical

Health Care Service Corporation•Helena, MT

1d•$121,200 - $225,200•Hybrid

About The Position

This is an opportunity for a motivated lawyer to provide strategic legal support to HCSC’s clinical team. In a highly complex and evolving legal and technology environment, the ideal candidate will provide sound, actionable legal advice on regulatory, business, contractual, and operational matters. A successful candidate will serve as a partner to our business leaders in developing adaptive strategies to support HCSC’s established business and to further its growth while continually advancing HCSC’s mission of expanding access to high-quality, cost-effective health care. The position can be based in Richardson, Texas; Chicago, Illinois; Tulsa, Oklahoma; Albuquerque, New Mexico; or Helena, Montana. Please note, this is a HYBRID position and requires in-office hours 3 days a week in the respective office location.

Requirements

Juris Doctor Degree and a license to practice law in the state where the legal department is located.
5 years’ experience as a practicing attorney after receiving a law degree.
Clear and concise verbal and written communication skills

Nice To Haves

Knowledge or understanding of the health care, health insurance, or claim administration field.
3+ years’ experience advising insurers, third-party administrators, or health plans on health plan administration, laws and regulations relating to commercial health plans (self-funded and fully insured), managed care plans, Affordable Care Act plans, HIPAA and relevant healthcare privacy laws, and other relevant federal and state healthcare laws.
Knowledge and understanding regarding federal and state fraud and abuse laws relating to health care and health plans, including but not limited to federal and state false claims acts, the federal Anti-Kickback Statute, Civil Monetary Penalties Law, and other similar laws.
Knowledge and understanding of federal and state laws that relate to health plan quality and performance improvement issues such as payment integrity, billing, and coding accuracy services, population health services, utilization management, prior authorization, and other quality and performance improvement initiatives.
Strong business collaboration and writing skills, including the ability to clearly provide legal counsel and solutions to complex issues.

Responsibilities

Provide prompt and actionable legal advice to business and legal partners on a variety of moderately complex projects or business offerings relating to health care management, clinical initiatives, benefit plan design, pharmacy and other miscellaneous initiatives.
Provide legal support on more routine day-to-day business matters with reasonable degree of independence.
Work with the business and legal colleagues to understand impact of and ensure compliance with new and proposed legislation, regulations, rules and court rulings. Support business in implementation of new requirements.
Work proactively with business and legal partners to identify and address potential regulatory, legal and business risks.
Exercise judgment and ability to manage competing deadlines.
Provide functional advice and guidance to legal support staff when assigned.
Collaborate with legal colleagues to identify legal issues with potential cross-functional impact.
Communicate and interact effectively and professionally with co-workers, management, customers, and other stakeholders.
Demonstrate ability and interest in learning and willingness to take on new challenges.
Comply with HIPAA, Diversity Principles, Corporate Integrity, Compliance Program policies, and other applicable corporate and departmental policies.
Maintain complete confidentiality of company business