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Job Summary
This is an opportunity for a motivated lawyer to provide strategic legal support to HCSC's clinical team. In a highly complex and evolving legal and technology environment, the ideal candidate will provide sound, actionable legal advice on regulatory, business, contractual, and operational matters. A successful candidate will serve as a partner to our business leaders in developing adaptive strategies to support HCSC's established business and to further its growth while continually advancing HCSC's mission of expanding access to high-quality, cost-effective health care.
The position can be based in Richardson, Texas; Chicago, Illinois; Tulsa, Oklahoma; Albuquerque, New Mexico; or Helena, Montana
Please note, this is a HYBRID position and requires in-office hours 3 days a week in the respective office location.
ESSENTIAL FUNCTIONS:
Provide prompt and actionable legal advice to business and legal partners on a variety of moderately complex projects or business offerings relating to health care management, clinical initiatives, benefit plan design, pharmacy and other miscellaneous initiatives.
Provide legal support on more routine day-to-day business matters with reasonable degree of independence.
Work with the business and legal colleagues to understand impact of and ensure compliance with new and proposed legislation, regulations, rules and court rulings. Support business in implementation of new requirements.
Work proactively with business and legal partners to identify and address potential regulatory, legal and business risks.
Exercise judgment and ability to manage competing deadlines.
Provide functional advice and guidance to legal support staff when assigned.
Collaborate with legal colleagues to identify legal issues with potential cross-functional impact.
Communicate and interact effectively and professionally with co-workers, management, customers, and other stakeholders.
Demonstrate ability and interest in learning and willingness to take on new challenges.
Comply with HIPAA, Diversity Principles, Corporate Integrity, Compliance Program policies, and other applicable corporate and departmental policies.
Maintain complete confidentiality of company business
JOB REQUIREMENTS :
Juris Doctor Degree and a license to practice law in the state where the legal department is located.
5 years' experience as a practicing attorney after receiving a law degree.
Clear and concise verbal and written communication skills
PREFERRED JOB REQUIREMENTS :
Knowledge or understanding of the health care, health insurance, or claim administration field.
3+ years' experience advising insurers, third-party administrators, or health plans on health plan administration, laws and regulations relating to commercial health plans (self-funded and fully insured), managed care plans, Affordable Care Act plans, HIPAA and relevant healthcare privacy laws, and other relevant federal and state healthcare laws.
Knowledge and understanding regarding federal and state fraud and abuse laws relating to health care and health plans, including but not limited to federal and state false claims acts, the federal Anti-Kickback Statute, Civil Monetary Penalties Law, and other similar laws.
Knowledge and understanding of federal and state laws that relate to health plan quality and performance improvement issues such as payment integrity, billing, and coding accuracy services, population health services, utilization management, prior authorization, and other quality and performance improvement initiatives.
Strong business collaboration and writing skills, including the ability to clearly provide legal counsel and solutions to complex issues.
LI-AZ1
LI-HYBRID
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Pay Transparency Statement:
At Health Care Service Corporation, you will be part of an organization committed to offering meaningful benefits to our employees to support their life outside of work. From health and wellness benefits, 401(k) savings plan, pension plan, paid time off, paid parental leave, disability insurance, supplemental life insurance, employee assistance program, paid holidays, tuition reimbursement, plus other incentives, we offer a robust total rewards package for employees. Learn more about our benefit offerings by visiting https://careers.hcsc.com/totalrewards .
The compensation offered will vary depending on your job-related skills, education, knowledge, and experience. This role aligns with an annual incentive bonus plan subject to the terms and the conditions of the plan.
HCSC Employment Statement:
We are an Equal Opportunity Employment employer dedicated to providing a welcoming environment where the unique differences of our employees are respected and valued. All qualified applicants will receive consideration for employment without regard to race, color, religion, sex, sexual orientation, gender identity, national origin, disability, protected veteran status, or any other legally protected characteristics.
Base Pay Range
$121,200.00 - $225,200.00
Exact compensation may vary based on skills, experience, and location.
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For more than 80 years, HCSC has been dedicated to expanding access to high-quality, cost-effective health care and equipping our members with information and tools to make the best health care decisions for themselves and their families. As an industry leader, HCSC also has been helping to make the health care system work better for all Americans. To remain a leader, we offer compelling careers that encourage resourcefulness, strategic thought and empower you to make a difference in the lives of our members and their communities.
Today, with the industry at an important crossroad, HCSC is reimagining health care and looking for original thinkers who aren't afraid to make innovative contributions. We are an Equal Opportunity Employment employer dedicated to workforce diversity and a drug-free and smoke-free workplace. Learn more about HCSC, our commitment to our members and the opportunity you'll have to improve health care delivery in an open, collaborative environment.
HCSC is committed to diversity in the workplace and to providing equal opportunity to employees and applicants.
If you are an individual with a disability or a disabled veteran and need an accommodation or assistance in either using the Careers website or completing the application process, you can call us at 1-866-977-7378 to request reasonable accommodations.
Please note that only requests for accommodations in the application process will be returned. All applications, including resumes, must be submitted through HCSC's Career website on-line application process. If you have general questions regarding the status of an existing application, navigate to "candidate home" to view your job submissions.
Blue Cross and Blue Shield of Illinois, Blue Cross and Blue Shield of Montana, Blue Cross and Blue Shield of New Mexico, Blue Cross and Blue Shield of Oklahoma, and Blue Cross and Blue Shield of Texas,
Divisions of Health Care Service Corporation, a Mutual Legal Reserve Company, and Independent Licensee of the Blue Cross and Blue Shield Association
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