drjobs Assistant General Counsel

Assistant General Counsel

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1 Vacancy
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Job Location drjobs

Des Moines, IA - USA

Monthly Salary drjobs

Not Disclosed

drjobs

Salary Not Disclosed

Vacancy

1 Vacancy

Job Description

Wellmarks Assistant General Counsel will assist and support the Executive Vice President & Chief Legal Officer in the performance representation and delivery of all legal compliance and regulatory services for Wellmark and its subsidiaries. This requires a thorough and in-depth understanding of the legal and regulatory environment affecting Wellmarks business and the health care industry. This individual will be accountable for reviewing analyzing preparing and communicating legal and regulatory issues that influence or impact Wellmarks business. In addition this individual will represent Wellmark with members stakeholders regulators and other external audiences.

The position is expected to have heavy emphasis on regulatory and compliance support of Wellmarks governmental healthcare programs including programs governed by the Affordable Care Act Medicare Tricare Federal Employee Program and ERISA. In addition to regulatory support this individual will be responsible for advising on and drafting of complex contracts.  This individual will provide support to Wellmarks product and sales team provider network administration team health and pharmacy services teams compliance teams and health plan operations. This individual will also have regular contact with state and federal regulators including CMS DOL Treasury and the Iowa and South Dakota Divisions of Insurance.

Ideal candidates will have experience providing legal and / or regulatory compliance advice in a healthcare setting or other highly regulated industry such as financial services utilities or other insurance sectors. You have exceptional interpersonal capabilities allowing you to build long-term productive relationships internally and externally. You embrace your role as an adviser and pride yourself on the ability to learn the business allowing you to consult with your stakeholders more effectively. If this sounds like you apply today!


Qualifications :

Required:

  • J.D. and current license in good standing to practice law (any state acceptable).
  • No history of federal or state professional disciplinary proceedings or regulatory disqualifications.
  • Continuing legal education must be current in accordance with state requirements for licensed attorneys.
  • 7 years of experience practicing law in a corporate governmental judicial or private practice environment in the subject areas of health care insurance administrative law antitrust finance employment law litigation and/or litigation management or related areas.
  • Advanced consulting and interpersonal skills. Ability to understand the needs of the business and develop legal advice that balances subject matter expertise with stakeholder needs. Viewed as a credible trustworthy business partner. Comfortable with decision making in a complex multi-dimensional team environment.
  • Ability to adapt and thrive in a constantly changing regulatory landscape.
  • Excellent research analytical and critical thinking skills. Strong understanding of applicable rules regulations and key interdependencies.
  • Effectively build relationships across the organization that are supportive and collaborative.
  • Strong oral and written communication skills with the ability to effectively articulate and support complex information and decisions to varied audiences.
  • Ability to understand the scope of your role and escalate matters for resolution when needed.
  • Proven ability to handle confidential information with discretion.
  • Proactive self-starter with strong time management skills and the ability to balance competing priorities with flexibility. Ability to anticipate risks assess impacts and take appropriate action.
  • Travel may be required.

Preferred:

  • Significant knowledge of insurance or health care industry.
  • Experience providing legal and / or regulatory compliance advice in healthcare setting or other highly regulated industry such as financial services utilities or other insurance sectors.
  • Experience advising health systems physician groups pharmacies Pharmacy Benefit Managers or other health care providers on contracting regulatory value-based payment clinical or operational issues.
  • Current license in good standing to practice law in Iowa and/or South Dakota or ability to become licensed on motion.


Additional Information :

a. Assist and support the Executive Vice President & Chief Legal Officer in achieving corporate and divisional goals and in maintaining corporate compliance with all applicable laws rules and regulations.

b. Provide appropriate and timely legal opinions or secure such opinions through management of outside legal counsel regarding legal strategies and positions for Wellmark and communicating such opinions to management CLO and/or CEO.

c. Provide proficient legal analysis and advice regarding business strategy and corporate transactions; analyze contracts and other legal documents; and provide legal advice to leadership all in a manner that is prudent innovative compliant with laws and best serves the strategic interests of Wellmark and its members.

d. Consistently anticipate evaluate develop mitigation strategies for and advise management of potential risks in contractual regulatory litigation compliance financial and reputational areas.

e. Keep current on new or changing state and federal laws and regulations applicable to government healthcare programs Wellmarks Qualified Health Plan Affordable Care Act Medicare Advantage Medicare Part D TriCare and Federal Employee Health Benefit Products provider network requirements utilization and care management and pharmacy benefits managers; assist management with designing and implementing business policies and procedures to assure compliance with same; and partner with compliance and business partners to review proposed and pending legislation on such topics.

f. Obtain and maintain advanced knowledge of laws governing the conduct of the Companys business including as applicable Affordable Care Act HIPAA ERISA and other state and federal laws.

g. Obtain and maintain an understanding of Wellmarks pharmacy and medical programs including building relationships with Pharmacy Benefit Manager other health providers.

h. Conduct confidential and/or privileged corporate investigations.

i. Review and approve corporate communications of all types for legal sufficiency and accuracy.

j. Prepare and review corporate and board of directors materials for legal sufficiency and accuracy.

k. Manage competing priorities effectively to meet corporate and divisional goals.

l. For all job accountabilities meet performance standards and comply with other job requirements as established and communicated by Company and Divisional leadership.

m. Be a great teammate.

n. Other duties as assigned.

An Equal Opportunity Employer

The policy of Wellmark Blue Cross Blue Shield is to recruit hire train and promote individuals in all job classifications without regard to race color religion sex national origin age veteran status disability sexual orientation gender identity or any other characteristic protected by law.

Applicants requiring a reasonable accommodation due to a disability at any stage of the employment application process should contact us at

Please inform us if you meet the definition of a Covered DoD official.


Remote Work :

No


Employment Type :

Full-time

Employment Type

Full-time

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