Assistant General Counsel

Boston, MA, United States

Position Summary

Under the direction of the WellSense Health Plan Chief Legal Officer, provides legal counsel and services to protect the interests of WellSense and BMC Health System and ensure that their affairs are managed in accordance with the law and policy.

Position: Assistant General Counsel

Department: Legal Affairs-WellSense

Location: Remote

Schedule: Full Time

Essential Responsibilities / Duties

Assumes a leadership role in ensuring the provision of legal counsel and the protection of legal rights for WellSense and, as appropriate, BMC Health System. Provides legal advice to the WellSense and BMC Health System community.

Independently handles legal matters and problems, including vendor contracts, provider service agreements, business associate agreements, intercompany agreements, managed care agreements, and various negotiations.

Manages corporate filings, responses to requests from state and federal regulators (including but not limited to New Hampshire Department of Health and Human Services, Massachusetts Executive Office of Health and Human Services, Massachusetts Division of Insurance and CMS), subpoenas and records requests, and interpretations of laws and regulations.

Works with operational departments to assist in management of regulatory and contractual requirements affecting the business of WellSense and BMC Health System.

Collaborates with Public Partnerships, Government Affairs, Compliance, and other departments to support the awareness and implementation of proposed and new legislation and regulatory requirements pertinent to the operation of WellSense and, as appropriate, BMC Health System. Assesses new requirements to provide guidance on timeframes, impacts, and magnitude of effort to meet regulatory compliance.

Collaborates with Compliance, Public Partnerships, and other departments on state and federal audits.

Participates in and manages litigation.

Supports or conducts the management of investigations with legal counsel for violations of law or policy.

Assists the development and review of WellSense and, as appropriate, BMC Health System policies and procedures.

Maintains an effective working relationship with corporate-wide contacts at all levels.

Resolves, or provides guidance on a variety of general business issues referred to the Office of General Counsel.

Reviews work to ensure conformity to established departmental policies and procedures, objectives, audit and regulatory standards.

Participates in the administration of the Office of the General Counsel.

Establishes and maintains effective working relationships with outside counsel, governmental agency lawyers and staff, regulators, various outside parties and lawyers.

Provides in-service education and conducts training seminars on a variety of legal issues.

Represents the department at meetings and participates on committees as directed.

Participates in activities that lead to continuous professional development such as seminars and conferences to keep abreast of legal developments and changes in regulatory environment.

Maintains membership in appropriate professional organizations and attends professional organization meetings.

Uses BMC Health System and WellSense values as the basis for decision making and to further the mission of WellSense and the Health System.

Performs other duties as needed.

Reads, understands, and follows the WellSense and Boston Medical Center Code of Conduct.

Education

JOB REQUIREMENTS

Juris Doctor degree from an accredited Law School required.

Certificates, Licenses, Registrations Required

Bar member in good standing within the state worked; multi-state desired, but not required.

Experience

Work requires knowledge of federal and state law applicable to the healthcare industry, including familiarity with managed care, reimbursement, privacy, and the current regulatory environment; of legal and procedural practices; of office and supervisory practices and procedures at a level generally acquired through at least five to ten years of varied legal experience with an emphasis on health plan-related issues.

Knowledge And Skills

Familiarity with behavioral health benefits and mental health parity preferred.

Work requires excellent oral and written communication skills.

Work requires analytical ability necessary to provide legal services and advice over a wide variety of legal issues; to draft legal documents; to negotiate contracts, transactions and settlements; and to determine appropriateness of appealing administrative decisions.

Work requires interpersonal skills necessary to provide a leadership role in ensuring the provision of legal counsel; to maintain an effective working relationship with corporate-wide contacts including senior management; to effectively communicate with all levels of employees; to establish and maintain effective working relationships with outside counsel, governmental agency lawyers and staff, various outside parties and lawyers; to instruct employees on various legal issues.

Work requires a working knowledge of computers including word processing and e-mail systems. Work requires the production of documents and letters with minimal secretarial support.

Equal Opportunity Employer/Disabled/Veterans

#J-18808-Ljbffr