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Senior Director, Legal Counsel-Dispute Resolution and Government Programs
Refer job# TBSE167741
 
Senior Director, Legal Counsel-Dispute Resolution and Government Programs Duties: In consultation with appropriate Law Department leadership, retain, oversee, and manage the work of outside counsel and ensure adherence to outside counsel budget. Recommend operational plans and strategies that directly impact the achievement of overall results for multiple departments and company-wide results, profitability, and/or public image of the organization. Under the direction of the Vice President, Deputy General Counsel, coordinate all litigation and investigation-related legal services required by Promise Health Plan (the Company's Medi-Cal affiliate) and's Medicare business as an integral member of the leadership teams. In consultation with Law Department leaders and the SVP/GC, establish legal policy and standards for the enterprise, and for the business and functional units served by the AGC. Manage the paralegal assigned to government programs litigation, arbitration, subpoenas, and regulatory enforcement matters. Work collaboratively with other attorneys, paralegals and litigation specialists specializing in commercial disputes. Provide guidance and training to's highly capable and valued legal support professionals. Defend Promise Health Plan and against litigation, arbitrations, investigations, subpoena response, and regulatory enforcement matters, in some cases directly, and in others, by supervising the work of outside legal counsel. Pursue litigation and recovery. Engage with government agencies in connection with subpoenas, enforcement actions, and investigatory demands. Partner with internal clients and paralegals to respond to discovery requests and investigatory demands. Provide timely, actionable advice and counsel to internal clients, enabling them to achieve their goals within a prudent range of legal risk, offering particular expertise in risks associated with government programs (Medicare, Medi-Cal).

Qualifications: Juris Doctorate degree required; superior academic credentials from a top-tier law school are strongly preferred. An active member of California State Bar. Must have 10 years of experience providing legal advice on relevant areas of the law (e.g., corporate, privacy, health care regulatory, litigation, contracts, et al) at a top law firm or in-house corporate law department. Should have 8 years of litigation experience, 5 of which include recent experience defending health plans, health insurers, or HMOs in litigation, arbitration, government investigations, subpoena response, and other formal or informal disputes. A combination of law firm and in-house experience is preferred. Demonstrated experience with contracted and non-contracted provider payment disputes. Possess strong knowledge and recent experience, providing actionable legal advice to business clients related to the Knox-Keene Act, False Claims Act, Stark laws, Medicare Advantage, Medicare Supplement, and Medi-Cal. Strong written and oral communication skills, analytical skills, intellectual curiosity, interest in diving into the facts, and ability to meaningfully communicate with business clients at all levels of the organization regarding complex legal matters.
 
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