Assistant General Counsel – Clinical - Health Care Service Corporation

PRACTICE AREAS:Business Law, Health
JOB TYPE:In-House

Company: Health Care Service Corporation
Position: Assistant General Counsel – Clinical
Location: Chicago, IL or Richardson, TX

Description: This is an opportunity for a motivated lawyer to provide legal support to HCSC’s health care management and clinical strategy and operations teams and other internal business partners supporting HCSC clinical initiatives across all lines of business. HCSC is the largest customer-owned health insurer in the United States, operating through its Blue Cross and Blue Shield plans in Illinois, Montana, New Mexico, Oklahoma, and Texas.

In a highly complex and evolving legal and technology environment, the ideal candidate will provide sound, actionable legal advice on regulatory, business, 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.

• 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), Medicare Advantage and Medicaid 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.
  • 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.