Associate Counsel - Central Health

The Associate Counsel – Healthcare Delivery is responsible for representing Central Health in legal matters and providing legal advice and counsel to the organization and its leaders related to healthcare delivery operations, compliance, contracting for healthcare services and Central Health’s practice of medicine and related operations as directed by the Chief Legal Counsel – Healthcare Delivery.

The Associate Counsel will support the development of Central Health’s Medical Executive Board and its P&T, credentialing, quality, peer review and clinical service line subcommittees and the health care compliance and risk components of the organization. The Associate Counsel will also advise on and support the ongoing operation of Central Health’s practice of medicine and its clinical operations, including matters that warrant consideration or awareness by the Medical Executive Board. The Associate Counsel will develop and implement programs, systems, policies and procedures to help prevent and mitigate both legal and compliance risks associated with Central Health’s functions as a health care organization. This positional role will work closely with operations, strategy, clinical services, finance, privacy, compliance, technology and HR departments as well as clinical, legal and operations leadership of the Central Health enterprise. Responsibilities include supervision of department staff and others as assigned.

This position is considered Hybrid, which means that individuals in this position may work both at an approved offsite location and onsite at a primary location or multiple locations based on business needs and as directed by the Chief Legal Counsel – Healthcare Delivery.

Essential Duties:
• Perform under general guidance and supervision with accountability for specific organizational and individual goals
• Support organizational goals and objectives to optimize the health of the covered population, reduce health disparities, and improve clinical outcomes, health equity, patient experience and costs of care throughout the delivery system
• Participate in the development, deployment and management of effective, efficient, and equitable clinical services to Central Health’s covered population through a variety of methods including contracted services, clinical services oversight, clinical support infrastructure development and oversight of direct service delivery
• Collaborate with others to build systems of care that provide adequate access to high quality care that meets or exceeds community clinical priorities and standards of care across all clinical service lines
• Support and advise others on the development of Central Health’s compliance and risk departments including development and maintenance of Central Health’s clinical and billing practices, medical staff governance and bylaws, pharmacy and therapeutics, network credentialing, privileging and other sub-committee functions of the medical executive board
• Participate in and advise on the planning and development of Central Health’s local indigent coverage plan structures and service offerings with an emphasis on population health management, medical necessity and the most effective use of limited resources in accordance with applicable laws and regulations
• Work collaboratively with others to support Central Health’s healthcare services annual contracting activities including contract renewals, periodic amendments, performance management, notices, and terminations as applicable
• Support Central Health contracting efforts for technology, professional services, equipment and supplies and other areas related to healthcare delivery including drafting, revising and negotiating a wide variety of complex documents including professional services agreements, educational and other affiliations, data sharing agreements, vendor contracts and healthcare provider employment arrangements.
• Collaborate with Vice President of Compliance and other compliance professionals who oversee compliance related to financial screening, eligibility and enrollment, provider credentialing and payment operations, vendor relations, service delivery contract performance management, benefit design, data privacy and security, medical case management and clinical services.
• Advise on and support the development of Central Health’s practice of medicine and clinical enterprise in accordance with applicable laws and regulations
• Research and review federal, state and local laws and regulations, including healthcare law, procurement and contract law, administrative law including applicable proposed legislation as needed to advise clinical and operational leadership fully and effectively
• Collaborate with other legal, procurement and compliance leaders and contractors supporting Central Health to ensure a coordinated approach to Central Health, compliance, legal matters and an efficient use of time and resources
• Serve as a liaison to various additional stakeholders including partner agencies, community healthcare providers, governing bodies, elected officials, public engagements, media outlets and others as assigned.
• Directly supervise and lead department paralegal and legal support staff as assigned
• Support the creation and implementation of programs, policies, operational processes and controls that build a culture of compliance with applicable laws and regulations
• Research, apply and promote healthcare industry best practices and recommend opportunities for better compliance and improvement
• Supervise additional staff as assigned
• Perform other duties as assigned

Knowledge/Skills/Abilities:
• Ability to lead a team of paralegals and support staff in the achievement of specific departmental goals
• Ability to thrive in a complex and dynamic work environment with multidisciplinary, cross-functional teams and matrixed team structures
• Demonstrated ability to prioritize multiple complex projects with varying deadlines and limited resources
• Ability to assess, advise and support the rapid development healthcare services
• Ability to effectively understand legal considerations related to service delivery and the practice of medicine
• Ability to apply critical thinking to generate and assess potential legal and practical solutions and to anticipate client needs in advance
• Ability to manage competing objectives in an ambiguous, fast-moving environment to achieve results
• Knowledge of best practice and industry standards for health care compliance, practice of medicine, healthcare operations, and safety-net healthcare policies and procedures
• Knowledge of laws, regulations and Central Health policies concerning county indigent healthcare programs, practice of medicine, healthcare contracting, data privacy, public procurement and existing Central Health agreements and affiliations
• Knowledge of data, measurement concepts, measurement tools and systems used to monitor and report clinical quality metrics, healthcare safety and other healthcare outcomes
• Compliance with data confidentiality and security laws, regulations, policies and standard operating procedures
• Ability to manage employees and interact with colleagues in a respectful, supportive fashion which encourages employee’s personal and professional growth
• High level skill at building relationships within the organization and with external partners
• Exceptional interpersonal skills with ability to interface effectively internally and externally with a wide range of people including colleagues, physicians, healthcare executives, community organizations and assigned staff
• Ability to persuade others to approach topics and ideas differently
• Strong attention to detail and accuracy
• Excellent verbal and written communications skills
• Ability to communicate complex ideas clearly and effectively through both writing and speaking
• Demonstrated ability to perform complex operations in Microsoft Office Suite
• Advanced skills in the area of project management, planning investigations and implementing initiatives

People Management/Department Management/Business Unit Management:
• Supports and models the vision, mission and values of Central Health
• Supervises and manages, either directly or indirectly, department staff as assigned
• Serves to support legal functions impacting clinical services and healthcare delivery operations
• Develops and maintains working relationships with Central Health colleagues that promote a desirable workplace and a culture of collaboration, professionalism and respect
• Uses problem solving, leadership, conflict management, and team building skills to ensure a productive work environment and achievement of goals
• Maintains a productive and motivated workforce through effective hiring, training, professional development, delegation and employee interaction
• Supports complex organizational change efforts
• Responds in timely manner to needs and concerns of colleagues, providers, staff and other stakeholders
• Develops and maintains a culture of compliance, collaboration, courtesy, customer service and professionalism
• Directs, supports, develops, coaches and acknowledges direct reports and department staff as assigned
• Performs objective annual evaluations of all direct reports
• Adheres to all local, state and federal laws and regulations and Central Health policies

MINIMUM EDUCATION: Bachelor’s Degree and Juris Doctorate degree from an accredited law school

PREFERRED EDUCATION: Master’s degree in a healthcare-related discipline.

MINIMUM EXPERIENCE:
• 3 years of legal experience in health care with demonstrated experience and practical knowledge of federal, state and local laws, regulations and standards of the healthcare industry, healthcare contracting, clinical operations and the practice of medicine.
• 1 year of corporate healthcare compliance experience at a law firm or health system.
• 1 year of experience of health care entity accreditation process and requirements, as well as federal, state and local regulations and statutes associated with the delivery of care and billing of private insurers and federal and state health care programs.

PREFERRED EXPERIENCE:
• 7+ years of combined legal experience in a public sector, safety net healthcare system working with a range of entities which may include federally qualified health centers, integrated delivery systems, health plans, healthcare districts, public health departments, hospitals, and physician specialty groups.
• 7+ years of healthcare compliance preferred including experience supporting and establishing compliance programs for new health care delivery environments, including aspects for data privacy and security, health care technology, contracting, and Joint Commission accreditation.
• 3 to 5 years working in a demanding and dynamic business environment.

REQUIRED CERTIFICATIONS/LICENSURE: License to practice law in the State of Texas

PREFERRED CERTIFICATIONS/LICENSURE: Certification in healthcare compliance, designation as Certified Professional in Healthcare Risk Management (CPHRM).