Staff Attorney WMS 2
Location: Olympia, Washington
Description: Washington State Health Care Authority is in need of Staff Attorney WMS 2 right now, this job will be arranged in Washington. For detail informations about this job opportunity please read the description below. **This recruitment may be used to fill multiple openings.** This job posting will remain open until filled. Screening of application materials will begin immediately and will be on-going. It is in the applicants' best interest to submit their applic ation materials as early as possible. The hiring manager reserves the right to make a hiring decision at any time. This job posting may be closed at any time without notice.
The Health Care Authority's (HCA) Office of Legal Affairs is seeking dynamic attorneys to join our team to provide services to the Medicaid Division or the Employees and Retirees Benefits Division.
We are looking for attorneys skilled at working across large diverse organizations, collaborating with cross functional teams, and capable of building and leveraging relationships to further the HCA's mission of providing high quality health care through innovative health policies and purchasing strategies.
Successful candidates will be organized, self-starters who are able to demonstrate their ability work collaboratively in a fast paced environment with minimal oversight.
About the Staff Attorney position:
Staff Attorneys in the Office of Legal Affairs represent HCA in complex cases at quasi-judicial administrative hearings before an HCA Presiding Officer or Administrative Law Judge (ALJ) and the HCA Board of Appeals (BOA) in a wide variety of case types. Depending on your assigned area, case types can range from state and school employees and retirees appeals of health benefit plans, COBRA, ERISA, self-insurance health plans, and Medicaid client appeals of medical service denials to large dollar provider overpayment appeals.
This position provides consultation to appeals and program staff and may directly present recommendations to senior and executive management based on legal education, experience and judgment. It also supports HCA's strategic initiatives to help ensure optimal success (and avoid legal challenges).
This position makes recommendations based on sound legal education, experience and judgment to the respective program as to their legal obligations and risks in coordination with the Attorney General 's Office, and assists in writing Washington Administrative Code (WAC) and program policies and processes. The position performs legislative bill analysis during the legislative session and may assist in the development of agency requested legislation.
This position serves as the back-up to the Supervising Staff Attorney and is an internal advisor to the agency's programs. In this capacity, the position serves as one of the agency's internal legal subject matter expert on employee health benefit plans, self-insurance plans, COBRA, ERISA, fee-for-service (FFS), managed care organization (MCO), and provider overpayments and works directly with the State Attorney General's Office in regards to litigation in which the agency is involved.
Some duties and tasks of this position:
Represents the PEBB, SEBB, Medicaid, or CHIP programs in complex cases at quasi-judicial administrative hearings before an HCA Presiding Officer or Administrative Law Judge (AL J), or HCA Board of Appeals (BOA) in a wide variety of case types ranging from state and school employees and retirees appeals of health benefit plans, self-insurance plans, COBRA, to recipient for FFS medical assistance cases, enrollee MCO appeals, and provider overpayment appeals in accordance with agency rules, the Washington Administrative Procedures Act, and all state and federal laws. When acting as an agency hearing representative, this position must research and prepare all legal pleadings, motions, and documents; prepare witnesses to testify at hearing; respond to Appellant's legal arguments and pleadings; and present the program's position at hearing.
Provides consultation to all level of staff including executive management related to program legal issues using sound legal education, experience, and judgment.
Identifies issues arising in adjudicative proceedings that may lead to potential litigation or adverse public reaction; and researches state and fede ral law and case law to determine possible problems that may lead to potential litigation and determines possible solutions to avoid litigation.
Competently drafts legal documents, rules, correspondence, position papers, training materials, policies and procedures appropriate to various audiences and purposes.
Reviews complex legal and technical documents, identifies key issues and points, explains them to others in plain English, and makes policy recommendations. This includes case analysis, identifying options and formulating recommendations for resolution based on sound legal education, experience and judgment.
Researches and interprets complex legal and medical issues, and concisely conveys this information to multi-level and diverse audiences via written memoranda and other media.
As assigned by a Supervising Staff Attorney, backs-up the Supervising Staff Attorney duties of acting as liaison to the Attorney General's Office on Program related legal matte rs and in civil litigation, coordinating the program's litigation defense strategy, and/or assisting with discovery. Materially contributes to identifying risk management strategies, proposing and drafting of technical requirements, and terms and conditions for contracts and competitive bidding processes involving the acquisition of medical, dental benefits, or other employee benefits for current and retired WA government employees and Medicaid enrollees. Participates as part of the OLA legal team, reviews draft rules, and recommends changes to rules or policies to mitigate agency risk and to comply with state and federal law.
Depending on your assigned area, case types can range from state and school employees and retirees appeals of health benefit plans, COBRA, ERISA, self-insurance health plans, and Medicaid client appeals of medical service denials to large dollar provider overpayment appeals.
Based on legal education, experience and judgment, provides consultati on to HCA staff in coordination with the Attorney General's Office regarding a wide array of issues dealing with PEBB, SEBB, CHIP, or Medicaid, including COBRA, ERISA, Internal Revenue Code, self-insurance health plans, outside third party administration issues, coordination of benefits, long-term disability, health savings accounts, flexible spending accounts FFS, MCO, and provider overpayments as assigned.
Maintains appropriate levels of confidentiality and compliance with applicable statutes, rules, HCA policies, and program procedures.
Responds promptly to external and internal customers using effective listening and interpersonal communication skills.
Helps capture and maintain data integrity through accurate and timely reporting of data and assists in the preparation of management reports.
An Ideal candidate will be able to:
Make tactical and strategic decisions and exercise significant professional discretion in determining how best to make a decision. Conduct legal research, seek out individuals with experience in the issue at hand, and consult with stakeholders regarding proposed decisions with diverse groups and individuals who are often employed in making appropriate decisions.
Required Education, Experience, and Competencies.
Juris Doctor degree from an ABA-accredited law school, and must be an active member in good standing of the Washington State Bar Association;
Ability to independently develop effective legal arguments and case management practices to ensure successful outcomes for HCA hearings;
Demonstrated history of regular and reliable attendance;
Knowledge of and experience with the rules of evidence, discovery, and civil procedure;
Handles customer questions and complaints in a pleasant and professional manner;
Meets commitments, works independently, is accountable and stays focused under pressure;
Deals with others in a straightforward and honest manner and maintains confidentiality;
Gives the appropriate attention to detail, shows a commitment to excellence, and regularly strives for quality improvement;
Listens to others, positively contributes to and promotes a team atmosphere;
Strong interpersonal communication skills;
Ability to problem solve, prioritize workloads, meet due dates, and provide independent strategic direction/decision making; and
Exceptional oral and written communication skills.
Preferred/Desired Education, Experience, and Competencies.
Demonstrated knowledge of Washington laws and rules pertaining to records retention, public disclosure and civil litigation and discovery;
Two years' experience in administrative hearings under the Washington Administrative Procedures Act and/or two years trial court experience;
Knowledge of federal and WA state laws relevant to the provision of employee benefits and health care: e.g. HIPAA, ERISA, COBRA, and the Internal Revenue Code;
Knowledge of Medicaid and PEBB regulations and programs;
Knowledge of the Washington state legislative process;
Knowledge of Medicaid and public health/assistance programs;
Knowledge about self-insurance health plans;
Knowledge of the federal Affordable Care Act and its anticipated effects on state agencies which procure and provide health benefits;
Knowledge of National Healthcare Reform in state and in federal government;
Experience analyzing legislation;
Knowledge about Health Savings/Spending Accounts;
Demonstrated experience in setting realistic and measurable goals;
Experience promulgating Washington Administrative Code;
Knowledge of WA state procurement and contracting laws and regulations;
Project management experience;
Experience drafting agency policies and procedures;
Three years' experience in the health insurance industry, including health benefits contracting and benefits procurement;
Experience formu lating legal defense strategies, preferably on behalf of state agencies;
Mediation experience;
Proven success working with diverse audiences.
How to Apply:
Only candidates who reflect the minimum qualifications on their State application will be considered. Failure to follow the application instructions below may lead to disqualification. To apply for this position you will need to complete your profile and attach:
A cover letter
Current resume
Three professional references
If you have questions about the process, or need reasonable accommodation, please contact the recruiter before the posting closes. The candidate pool certified for this recruitment may be used to fill future similar vacancies for up to the next six months .
Washington State is an equal opportunity employer. Persons with disabilities needing assistance in the application process, or those needing this job announcement in an alternative format may ca ll the Human Resources Office at 360.725.0945 or email Sidra.Fields@hca.wa.gov
- Prior to a new hire, a background check including criminal record history will be conducted. Information from the background check will not necessarily preclude employment but will be considered in determining the applicant's suitability and competence to perform in the position. *
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If you were eligible to this job, please deliver us your resume, with salary requirements and a resume to Washington State Health Care Authority.
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This job starts available on: Fri, 23 Feb 2018 21:02:55 GMT