Excellent Benefits Package!!!
Location: Gastonia, but may be negotiable for Hickory or Elkin for the right candidate
Projected Hiring Range: $53,964 - $56,805
Closing Date: Open Until Filled
Primary Purpose of Position: To provide executive-level legal specialist services for the Legal Department aka Office of General Counsel (OGC) and its Chief Legal Officer/General Counsel (CLO/GC). Modeled from the NC DHHS Agency Legal Specialist II job description, this position entails professional legal work with specialization in a variety of legal/programmatic areas or functions, including but not limited to litigation, transactions, regulation, legislation, internal and external dispute resolution, Partners’ policies and procedures, and other aspects of North Carolina Medicaid and non-Medicaid managed behavioral healthcare. A key role will be to serve as a centralized coordinator and/or liaison of wide variety of legal processes handled by Partners via diverse procedures and business units, including provider, consumer and grievant/complainant disputes. Will also be primary communication contact for OGC and key coordinator of contracts and other transactional work for Partners initiated in other departments and requiring legal advice. Examples of other work include public records requests, participation in managerial conferences, assessment of the impact of proposed Federal or State legislation, explanation of proposed legislation to key Partners stakeholders including Regulatory Compliance Committees, research and compliance with the Administrative Procedures Act, representing Partners or assisting in administrative hearings where permitted, drafting or reviewing contracts, providing technical information or support to the OGC, creating and maintaining metrics for department, and helping with engagement of and billing by outside counsel. Work closely with Program Integrity Director, Waiver Contract Manager, Legal Specialist/Dispute Supervisor and their departments, also located in OGC. Position reports directly to Chief Legal Officer & General Counsel.
NOTE: Representation of Partners in a court of law and other acts constituting the practice of law are the responsibilities of attorneys in or for the OGC. Position will cooperate with, assist and take significant responsibility for preparation of work by attorneys, but have no authority to act as legal counsel for Partners to extent deemed practice of law without first being properly licensed in good standing.
Under licensed-attorney supervision where required, this position: 1) performs legal research, drafting, review, proofing and communications regarding contracts, litigation, subpoenas, hearing notices, pleadings, motions and related legal projects; 2) fields, routes and/or addresses (or ensures licensed attorney addresses) legal issues and questions from various Partners’ business units and staff; 3) interprets and assists in developing and maintaining relevant policies and procedures (P&Ps); 4) assists with preparation for and occasional participation in executive and board level meetings and other events involving the CLO/GC; 5) creates, maintains, analyzes and reports key OGC metrics; 6) ensures monitoring, prompt routing, payment and reimbursement of legal bills and expenses, including maintaining the OGC legal matters management and invoicing software and database; 7) is a key liaison and coordinator from OGC for all due processes of Partners, including but not limited to provider disputes, consumer disputes and grievances/complaints; and 8) other duties as needed consistent with an executive level professional legal specialist. Works with extremely sensitive and confidential information and records.
Role and Responsibilities (percentages are approximations):
70% Professional Legal Specialists Services – Disputes, Transactions, Litigation, Metrics/Goals and Communications:
Under licensed-attorney supervision where required, provide complex legal specialist services. Examples include performing legal research, both formal from traditional legal research databases and from non-traditional resources such as State and Federal legislative and regulatory websites.
Required to consult CLO/GC for supervision on matters and in any instance that might be construed as the practice of law.
20% Analytical and Organizational Services:
Create, maintain, analyze and report key OGC metrics using various OGC-specific resources and interdepartmental support. Ensure engagement, monitoring, prompt routing, payment and reimbursement of legal bills and expenses, including maintaining the OGC legal matters management and invoicing software and database, CounselLink. Communicate with outside counsel regarding pending assigned cases and legal matters, billing guidelines and other needs. Help develop, implement, monitor and meet OGC departmental goals. Liaise with OGC staff (e.g., Grievances and Program Integrity) regarding data from and about their functions and outcomes.
10% Other Duties and Projects as Assigned. Provides comprehensive administrative support to OGC and CLO/GC not covered by other staff. Coordinates and assists with highly visible functions and events, including substantive preparation of CLO/GC for Board, Executive Leadership, Operations Team, Management Team and other meetings; CFAC and provider forums, council and other meetings; legal trainings; various relevant committees and other events involving OGC functions or staff. Work with Executive Assistant to make room reservations, including IT needs; schedule and coordinate select conference calls, mediations, and hearings; maintain OGC legal files and records; and miscellaneous OGC operational matters. Back-up duties for OGC key functions and staff, including contract waiver management, grievance coordination and P&Ps.
In all roles and responsibilities, assures confidentiality of information of a sensitive nature within the department and organization. Adheres to court, regulatory, Partners’ and other deadlines. Highly organized and digitally proficient, and able to multitask in fast-paced, detail-oriented environment. Maintains a thorough understanding of legal procedures and documents. Able and authorized to exercise good judgment in a variety of situations when communicating directly with persons within and outside Partners, including attorneys, judges, regulators, clinicians and others. Strong oral and written communication skills essential. Significant attention to accuracy. Excellent people skills.
Knowledge, Skills and Abilities:
Education and Experience Required: Graduation from an accredited law school and at least two years of related professional legal or programmatic experience; or an equivalent combination of education and experience. Knowledge of and experience/proficiency with legal online legal research, matter management, billing and e-filing databases, resources and solutions and state and federal legislative and regulatory websites. Extensive knowledge and proficiency of Microsoft Office products (Word, Excel, Outlook, PowerPoint, etc.). Comfort and experience with electronic modes of communication, filing, record keeping and office management.
Education and Experience Preferred: Experience in healthcare, especially public behavioral health, managed Medicaid, and healthcare payor systems and law. Knowledge of and experience/proficiency with LexisAdvance, CounselLink, WestLaw and e-OAH.
Licensure/Certification Requirements: None, including law license not required.