Overview

Job Details
Description
Advise CenCal Health management on all legal matters pertaining to Medi-Cal and any other health plans or programs administered by CenCal Health
Advise management on organizational strategy and development, including consideration of both legal and non-legal issues, such as financial and operational concerns
Serve as legal counsel to CenCal Health’s Board of Directors; attend all Board of Director meetings and ensure that such meetings are conducted in strict adherence to Brown Act provisions and CenCal Health’s Bylaws; draft and approve Board resolutions and other Board documents as required; ensure compliance with all requirements of public agency law, including Public Records Act and Political Reform Act
Negotiate and draft or review provider and vendor contracts and contract revisions; deal with contractual nonperformance issues and contract terminations
Respond to HIPAA compliant Public Record Act, Member Record requests and subpoenas for records
Assist outside employment counsel to CenCal Health in advising the Human Resources Director on labor and employment law issues
Act as legal counsel to the CenCal Health Credentialing and Peer Review Committee
Prepare for and represent CenCal Health at State member or provider administrative hearings and draft any related position statements or other documents
Retain and manage outside counsel where required for litigation, legal opinions or expertise on specific matters
Respond to specific issues as they may arise, including researching law and facts and developing solutions both independently and collaboratively
Manage a staff of two Associate Legal Counsel and two Legal Specialists
Other duties and projects as assigned by the Chief Executive Officer

Qualifications
Education
Required

Doctorate or better in Law.

Experience
Required

Graduation from an ABA-approved law school
Active California State Bar License
Experience in government agency and contract law
Excellent knowledge of core operation functions of a managed care organization
Experience with Federal and California managed care regulations and mandates
10 years: Experience in managed healthcare and/or public agency law


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