Download App | FOLLOW US ON SOCIAL MEDIA
 Upload Your Resume   Employers / Post Jobs 

Litigation - General/Commercial Attorney in Sacramento, CA

California Department of Managed Health Care Sep 13,2020 Location Sacramento CA
This job is expired...

Government

Attorney

Litigation - General (consumer)

Min 1 yrs required

Profile

Legal Counsel Iii -Part-Time The candidate under the direction of the Assistant Chief Counsel, in the Office of Plan Licensing performs sensitive and complex legal work for the Department of Managed Health Care. Duties include providing direction and leadership on filings for License Applications and Material Modifications and Amendments to license applications. The work entails legal review, legal research, and applying the law in connection with the administration and regulation of persons licensed pursuant to the Knox-Keene Health Care Service Plan Act of 1975, including the implementation of Federal Health Care Reform. Duties involve communication with licensees and coordination with other divisions/offices on filings and matters concerning licensees. In addition, performance encompasses work relative to Specialized Plans, e.g. data collection and analysis, and other special projects, as required. The role of the Office of Plan Licensing (OPL) is to provide timely review of new license applications, material modifications, amendments and other filings to ensure that plan documents and materials comply with applicable state and federal laws and regulations. Duties include providing direction and leadership pertaining to plan benefits and plan and provider payment, risk and delegation arrangements, implementation of compliance with Director’s Letters, review of complex legal matters and conduct legal research in connection with the administration and regulation of health plans pursuant to the Knox-Keene Health Care Service Plan Act of 1975 (Act) and the implementation of Federal Health Care Reform. Performs with broad discretion and independence, the review of health plan filings including applications, amendments, notices of material modification, reports and transactional documents submitted pursuant to the Act or federal health care reform for compliance with appropriate law. Incumbent leads stakeholder meetings and filing conferences with applicants, licensees and other offices. As an expert reviewer, identifies contract changes required for providers and administrative service contracts; analyzes and assesses Evidence of Coverage and disclosure forms; evaluates benefits; and reviews subscriber contracts and disclosures, advertising and other marketing documents. Communicates and coordinates with other divisions regarding issues in filings under their purview. On complex matters, researches and analyzes federal and state laws and regulations regarding the Department’s administration of the Act, federal and California health care reform, including Covered California issues, and prepares written findings of that research. Evaluates the impact on licensee operations of the Act and relevant provisions of other California Codes especially the Government Code, Business and Professions Code, Corporations Code, Welfare and Institutions Code and non-Act provisions of the Health and Safety Code. Drafts written communications to colleagues, division managers and supervisors, external stakeholders and other persons as necessary. Provides information regarding plan licensure as requested by management. Independently or in collaboration with counsel and other Department programs, composes interpretive analysis/assessment of new or proposed legislation. Drafts legal and fiscal analyses of the implementation of proposed or new legislation. Prepares legislative analyses to identify where issues intersect with the application of rules or statutes relating to the effective implementation of plan issues. Drafts proposals to implement, interpret and provide guidance to management regarding statutes and regulations. Leads or participates as a subject matter expert in internal and external departmental workgroups related to compliance issues. Researches and gathers data pertaining to filing review. Should be familiar with mission, goals, organizational structure and major work programs; demonstrate a positive attitude and a commitment to conduct business in a professional manner in dealing with the public and department clients; provide quality customer service to all customers; and deal tactfully, professionally and confidentially with all internal and external customers and contacts.

Qualification and Experience

The candidate requires an Active CA Bar License. Must have knowledge of legal research methods and performing research; legal principles and their application; scope and character of California statutory law and of the provisions of the California Constitution; principles of administrative and constitutional law; administrative law and the conduct of proceedings before administrative bodies; legal terms and forms in common use; statutory and case law literature and authorities; and provisions of laws and Government Code sections administered or enforced. Should have ability to research; analyze, appraise, and apply legal principles, facts, and precedents to legal problems; analyze situations accurately and adopt an effective course of action; prepare and present statements of fact, law, and argument clearly and logically in written and oral form; prepare correspondence involving the explanation of legal matters; draft opinions, rulings, regulations, and legislation; negotiate effectively; work cooperatively with a variety of individuals, organizations and maintain the confidence and respect of others; and work effectively under pressure.

Filing Deadline: 9/21/2020.

Additional info

Ref JC-215582

Company info