Central California Alliance for Health · 10 hours ago
Legal Services Director
California, United States
Full-time
Hybrid
Mid, Senior Level
$207K/yr - $331K/yr
7+ years expCentral California Alliance for Health is a regional non-profit health plan committed to providing accessible, quality health care guided by local innovation. They are seeking a Legal Services Director to oversee the Legal Services Department, providing strategic management and legal counsel while managing litigation and administrative contracting.
GovernmentHealth CareHealth InsuranceHospital
No H1B
U.S. Citizen Only
Responsibilities
Provides strategic management oversight in implementing, directing, and monitoring the Alliance’s Legal Services Department, which provides advice and counsel and performs enterprise risk management for Alliance operations
Directs the Legal Services Department, acts as a leader and subject matter expert and provides direction and advice on legal and administrative contracting issues and overall business operations
Manages and coordinates litigation and disputes related to Alliance operations
Directs health plan administrative contracting, including maintenance of agreements and negotiation and re-negotiation of contracts in coordination with Alliance staff and external counsel
Directs, manages, and supervises Legal Services Department staff
Qualification
Required
Juris Doctor degree from an accredited law school, admitted to and in good standing with the State Bar of California, and possession of an active license to practice law in California
A minimum of seven years of experience as a practicing health care attorney performing research and analysis of legal, statutory, and regulatory information, which included a minimum of five years of management level experience and a minimum of three years of experience related to health plan operations; or an equivalent combination of education and experience may be qualifying
Knowledge of health care laws
Knowledge of Knox-Keene Health Care Service Plan Act and Regulations, Affordable Care Act, Health Insurance Portability and Accountability Act (HIPAA), Stark Law, and False Claims Act
Knowledge of Medi-Cal, Medicaid, and Medicare rules, requirements, and regulations
Knowledge of state regulatory agencies, such as DHCS, Centers for Medicare and Medicaid Services (CMS), and Department of Managed Health Care (DMHC)
Knowledge of principles and practices of operational oversight and program and project management
Knowledge of principles and practices of contract negotiation and review
Ability to provide prudent legal recommendations and counsel to executive team members and Board members
Ability to develop legal strategies and objectives based upon analysis of relevant information and resources, and make recommendations
Ability to perform risk assessment, anticipate and respond to risks, and provide risk mitigation support
Ability to provide leadership, facilitate meetings, and partner with and guide managers and employees in the resolution of issues
Ability to act as a technical resource and explain complex laws, regulations, processes, and programs related to areas of responsibility
Ability to review and assess overall department function, core work, goals, and structure, develop and implement short- and long-term planning to achieve strategic plans, and complete an annual department assessment
Ability to direct, manage, supervise, mentor, train and evaluate the work of staff
Benefits
Medical, Dental and Vision Plans
Ample Paid Time Off
12 Paid Holidays per year
401(a) Retirement Plan
457 Deferred Compensation Plan
Robust Health and Wellness Program
Onsite EV Charging Stations
Company
Central California Alliance for Health
The Alliance is a state-funded health plan that provides Medi-Cal insurance to Mariposa, Merced, Monterey, San Benito & Santa Cruz counties.
501-1000 employees
Funding
Current Stage
Late StageLeadership Team
Michael Schrader
Chief Executive Officer
Lisa Ba
Chief Financial Officer
Recent News
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