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Litigation - Health Care Attorney / Litigation - White Collar Crime Attorney in Phoenix, AZ

Arizona Health Care Cost Containment System (AHCCCS) Mar 26,2019 Feb 12,2019 Location USA Phoenix AZ
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Government

Attorney

Litigation - Health Care

Litigation - White Collar Crime & Government Investigations

Min 1 yrs required

Profile

Deputy General Counsel - Health Care The candidate will perform legal research, provide legal advice, and prepare related legal documents (contracts, intergovernmental agreements, operational protocols, and agency policies) consistent with state and federal law regarding all aspects of the administration of the program with an emphasis on providing advice to the AHCCCS Office of the Inspector General regarding provider and member fraud, provider participation, collections, and program integrity efforts. Negotiate and draft settlement agreements and correspondence relating to diverse contested matters including civil monetary penalties for fraudulent claims and eligibility fraud, credible allegations of fraud, provider claim disputes, collection issues, and other matters. Supervise professional staff, including attorneys and paralegals. Coordinate efforts with the Medicaid Fraud Control Unit of Office of Arizona Attorney General and other State/Federal law enforcement entities such as the United States Attorney's Office and County Attorneys' Offices on issues related to the administration of the program including matters relating to health care providers participation and civil penalties, credible allegations of fraud, and criminal prosecutions for provider and member fraud. Coordinate, assist, and oversee work performed by outside counsel assigned to various litigation matters for the agency. Represent the Agency in various judicial and administrative proceedings regarding the administration of the program including complex matters relating to civil penalties for provider and member. Respond to discovery requests, subpoenas, & public records requests while ensuring compliance with state & federal privacy requirements. Review of proposed state and federal statutes and regulations affecting the program and advise the administration and Governor's Office on potential impacts. Assist with the drafting of formal administrative rules and policy consistent with program requirements and agency objectives. Perform review and analysis of trusts associated with applications for benefits for compliance with legal and program requirements. Approve or deny trusts pursuant to 42 U.S.C 1396p, recommending amendments to trust in order to qualify for program eligibility and providing oversight of trust reviews. Review Administrative Law Judge Recommended Decisions & prepare Director Decisions & Final Decisions.

Qualification and Experience

The candidate must have Juris Doctorate degree from an accredited law school. Must be licensed to practice law in Arizona and in good standing. Must have knowledge of health care compliance. Should demonstrated knowledge of regulations of managed care delivery systems and health care provider reimbursement. Should have strong organizational and interpersonal skills and ability to work effectively and professionally with AHCCCS, other state agency personnel and third parties. Experience in prosecution or defense of False Claims Act, Healthcare fraud, white collar crime and/or similar matters involving fraud, waste, and abuse preferred.

Additional info

Job Reference #: 44743

Company info