Description:

An IT Service Management Company is currently hiring for a Manager - Legal to join our California Behavioral Health Investigations and Medical Survey team. This is a remote opportunity. The team conducts audits (surveys) of Managed Health Care commercial and Medi-Cal health plans in the state of California. The client is the California Department of Managed Health Care (DMHC), Division of Plan Surveys (DPS). We are a clinical vendor for the client, with a team of clinical staff (clinicians and nurses) with varied backgrounds and educational and work experiences. The Manager - Legal has the integral role of supporting the Project Director in the overall management of the project, as well as serving as a subject matter expert on managed health care statutory and regulatory requirements and legal report writing.

Essential Duties and Responsibilities:
  • Manage Project Management team in the planning, monitoring and execution of all projects within the portfolio.
  • Build project management expertise within the team and develop best practices.
  • Coordinate and evaluate the work of the Project Management team.
  • Ensure exposure to risk is minimized on all projects.
  • Provide accurate and timely communication to leadership regarding risks, issues and plans to address each.
  • Provide recommendations to leadership to improve business and project processes to achieve improved results.
  • Monitor performance of subordinates according to established monitoring standards; conduct performance appraisals, make decisions on personnel actions including hiring, firing, and disciplinary action.
  • Provide subject matter expertise in California managed health care laws and regulations.
  • Research California managed health care laws, regulations, and plan contracts to ensure proper application of statutory and regulatory requirements, and maintain working knowledge for application to current and anticipated project needs
  • Monitor survey calendar and ensure milestones for surveys are met
  • Quality review of survey pre-onsite and post-onsite client deliverables
  • Write and update survey process documentation; assist with revising or developing, as appropriate, policies and procedures at the project and the corporate level to maintain contractual, regulatory, and statutory compliance
  • Review, revise and edit survey reports to ensure accurate factual findings and legal citations/support
  • Participate in virtual and on-site surveys as assigned
  • Participate in staff, survey and client meetings
  • Manage or contribute to, as appropriate, the development of project staff training and training materials
  • Respond to ad-hoc questions from internal and external clients
  • Communicate project and client policies, procedures and practices to all team members as needed
  • Maintain good standing with applicable state bar through continuing education
  • Other duties as assigned

Minimum Requirements:
  • Bachelor's degree with 5-7 years of project management experience, or equivalent combination of education and experience..
  • Knowledge of workflows and project mapping.
  • Able to handle multiple tasks and competing priorities.
  • Strong ability to communicate updates and project status effectively and efficiently.
  • Juris Doctor (JD) from an accredited law school, required
  • Bar admission strongly preferred
  • Minimum of three (3) years of experience in managed health care preferred; other work or educational experience taken into consideration
  • Ability to read and interpret statutes and regulations with ability to translate complex legal requirements into practical operations advice
  • Strong organizational skills, attention to detail, analytical skills, and problem-solving capabilities with excellent interpersonal, written, and verbal communication skills
  • Ability to manage multiple priorities in a fast-paced, organizationally complex, deadline-oriented work environment
  • Ability to work collaboratively with multiple stakeholders
  • Excellent verbal and written communication skills
  • Audit experience, including interviewing and fact finding, preferred
  • Must be a team player and have the willingness to continue to learn and evolve in the position
  • Must be able to work independently and exercise good judgment
  • Heightened awareness of business ethics and compliance
  • Proficient in Microsoft Office (Word, Excel) required