California Department of Managed Health Care · 7 hours ago
Senior Networks Attorney
United States
Full-time
Remote
Senior Level
$10,852/mo - $15,325/moThe California Department of Managed Health Care (DMHC) is dedicated to ensuring health plan members have access to equitable and high-quality health care. They are seeking a Senior Networks Attorney to perform complex legal work related to provider networks and compliance with the Knox-Keene Act, including developing regulations and reviewing health plan networks for adequacy and access requirements.
ComplianceGovernmentHealth Care
No H1B
Security Clearance RequiredU.S. Citizen Only
Responsibilities
Perform complex legal work related to ensuring that licensed health care service plans maintain adequate provider networks and deliver timely access to services as required under applicable provisions of the Knox-Keene Act
Serve as a lead attorney for development of regulations related to network adequacy and measurement methodologies to evaluate a health plan's ability to cover required benefits
Review health plan networks for compliance with network adequacy and timely access requirements, which may include review of annual submissions, health plan license applications, notices of material modifications to existing health plan licenses, amendments to existing health plan licenses, revisions to access-related policies and procedures, and block transfer notifications for compliance with network adequacy requirements
Provide counsel and advice to personnel within the OPM, interact with individuals throughout the DMHC and within external organizations, and report directly to the Assistant Chief Counsel for the Division of Provider Networks
Qualification
Required
Possession of Minimum Qualifications will be verified prior to interview and/or appointment
A Statement of Qualifications (SOQ) is a mandatory requirement to apply for this position
The position(s) require(s) a Background Investigation be cleared prior to being hired
Preferred
Attorney work experience in public service, public interest, administrative law, consumer advocacy, health care, worker's compensation, licensing or insurance
Non-legal work and educational experience with conducting research, writing in health care, health care advocacy, consumer advocacy or regulatory compliance
Knowledge of health care service plan programs and trends pertaining to Provider Networks
Familiarity with health care delivery models and issues related to the provision of health care services
Clear and concise writing skills with an ability to think critically about the way all written materials will be interpreted and applied in conjunction with existing law
Comfort with interpreting data and understanding statistical analyses for the purpose of determining legal compliance
Ability to organize and establish simultaneous workload priorities and work under pressure
Exercise a high degree of initiative, flexibility, and confidentiality
Ability to work independently, as well as cooperatively and effectively with others
Ability to professionally communicate both orally and in writing
Ability to reason well and use good judgment
Dependable, punctual, and excellent attendance
Proficient use of the following Microsoft software programs: Access, PowerPoint, Word, and Excel
Familiarity or comfort with learning geographic mapping software such as Quest Analytics or ArcGIS
Company
California Department of Managed Health Care
California Department of Managed Health Care is a government body that provides health plan oversight and consumer complaint assistance.
Founded in 2000
201-500 employees
Funding
Current Stage
Growth StageLeadership Team
Chris Jaeger, MD, MBA
Chief Medical Officer
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