Assistant General Counsel

ASSISTANT GENERAL COUNSEL
The Assistant General Counsel supports and reports to the Chief Legal Officer and provides legal advice on a wide variety of matters related to Community’s Medicare, Medicaid and Marketplace programs and operations including contracting, quality, utilization management, network management, privacy and security, litigation, fraud, waste and abuse, and contractual and regulatory compliance.
JOB SPECIFICATIONS AND CORE COMPETENCIES:Collaborate regularly with members of the legal team to help streamline work, legal operations and effective risk management.Manage day-to-day legal issues including vendor and provider contracting, privacy, litigation/disputes, compliance and regulatory matters.Ensure timely and effective management of legal requests.Work effectively within a Legal Operations infrastructure that is innovative, cost effective and scalable as the organization and team grow.Assist operational leadership and managers in managing vendor selection and performance and resolving disputes.Assist the Chief Legal Officer as needed with Board and other governance issues and special projects.Ensure effective collaboration with stakeholders including within Community Health Choice and externally, including Harris Health.Maintain current knowledge, monitor changes, and provide research on Community’s legal requirements including but not limited to licenses, certifications and accreditations as well as the requirements of the Texas Administrative Code, Texas Insurance Code, Health and Human Services Commission (HHSC), Texas Department of Insurance (TDI), Health and Human Services (HHS), Centers for Medicare and Medicaid Services (CMS), and other regulatory entities.Demonstrate Harris Health and Community Health Choice values, including trust, integrity, mutual respect, diversity, responsiveness and caring service.Actively contribute to achievement of departmental goals, as identified in Department’s annual business plan, including specific departmental process improvement plans.Collaborate regularly with members of the legal team to help streamline work, legal operations and effective risk management.Manage day-to-day legal issues including vendor and provider contracting, privacy, litigation/disputes, compliance and regulatory matters.Ensure timely and effective management of legal requests.Work effectively within a Legal Operations infrastructure that is innovative, cost effective and scalable as the organization and team grow.Assist operational leadership and managers in managing vendor selection and performance and resolving disputes.Assist the Chief Legal Officer as needed with Board and other governance issues and special projects.Ensure effective collaboration with stakeholders including within Community Health Choice and externally, including Harris Health.Maintain current knowledge, monitor changes, and provide research on Community’s legal requirements including but not limited to licenses, certifications and accreditations as well as the requirements of the Texas Administrative Code, Texas Insurance Code, Health and Human Services Commission (HHSC), Texas Department of Insurance (TDI), Health and Human Services (HHS), Centers for Medicare and Medicaid Services (CMS), and other regulatory entities.Demonstrate Harris Health and Community Health Choice values, including trust, integrity, mutual respect, diversity, responsiveness and caring service.Actively contribute to achievement of departmental goals, as identified in Department¿s annual business plan, including specific departmental process improvement plans.
QUALIFICATIONS:Doctor of Jurisprudence/JD degree; license to practice law in State of Texas or ability to apply for and meet in-house corporate counsel requirements under Texas Bar Admission Rules.Licensed three – seven years with a minimum of three years managed care experience in a health plan or law firm required.Knowledge of Medicare, Medicaid, CHIP, Marketplace, and other government managed care programs preferred.Experience with provider affiliated health system health plans a plus.
OTHER SKILLS:Software Proficiencies: Microsoft OfficeExperience with contract management systems and legal operating systems including e-billing, matter management and CLM tools preferred.Knowledge of a combination of health insurance and Medicaid, Medicare, Marketplace operations, regulations and compliance requirements.Familiarity with HIPAA privacy and security regulations.Experience supporting middle and upper management required.
**Must be licensed in Texas or able to obtain Foreign Legal Consultant certification under State Bar Rule 14**