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AI Summary

The Staff Attorney manages and oversees legal matters to ensure compliance with federal and state regulations across Medicare Advantage and commercial business segments. Responsibilities include drafting and reviewing contracts, conducting legal research, and serving as lead counsel in administrative hearings and disputes.

Job Details: Job Location: Any Location Remote US - Oklahoma City, OK, Position Type: Full Time, Education Level: Graduate Degree, Salary Range: Undisclosed, Travel Percentage: Occasional, Job Shift: Day, Job Category: Legal, WHO WE ARE: GlobalHealth is a fast growing Medicare Advantage HMO health insurer. We aspire to be the employer of choice in our industry, attracting and retaining a highly talented workforce. Our passion is Genuine Care and Optimal Health for the members we serve. We are unique by providing high touch, high value and a partnership to our members. We go above and beyond to provide personalized, engaging, and responsive services to our members. We work hard to offer affordable health insurance coverage with the benefits people truly want and need. It is our hope to be more than just a health insurance company we want to be long-term partners with our members. We are looking for future employees who exude our core values of taking accountability through ownership, being driven, innovative and who have a passion for continuous learning.   WHO YOU ARE: Manages, leads, and oversees legal matters to ensure compliance with all applicable laws and regulations.  Responsible for the regulatory and legal guidance to comply will all applicable laws and regulations for the Medicare Advantage, Commercial, and any other business segment. Provides professional guidance to the Legal department and key areas of the organization. Reporting to the Legal Department, this position is responsible for contract review and record management, drafting legal opinions/memos, researching legal/compliance questions, and reviewing materials and company correspondence to ensure compliance with applicable laws and regulations.     ESSENTIAL JOB FUNCTIONS: Oversees in-house contract management.  Drafts, reviews, and edits written contracts within contract management system in compliance with applicable laws and/or regulations.  Organizes and ensures appropriate retention of documents as required. Conducts legal/regulatory research and provides guidance and recommendations to employees and management team.  Reviews marketing materials, outgoing correspondence, memos, file documents, etc. for regulatory compliance. Resource for legal and regulatory compliance matters.   Prepares written reports, legal memos, and correspondence. Drafts written responses to regulatory agency requests, audits, and investigations. Informs to supervisor of significant legal/regulatory compliance matters and concerns and makes recommendations. Investigates possible violations of laws, regulations, rules, policies, procedures, and/or Code of Conduct and recommends appropriate action (e.g., disclosure, reporting to regulatory agency/authority, disciplinary action, etc.). Serves as lead counsel in representation of the company in certain disputes, including Independent Dispute Resolution and Administrative Law hearings.  Monitors changes in federal and state legislation and educates company stakeholders on upcoming changes that may or will impact operations.  Serves as a liaison with outside counsel engaged for litigation and arbitration matters and serves as a liaison between outside counsel and company leadership. Must maintain confidentiality of business information, including Protected Health Information (PHI), as required by HIPAA and company policy. May carry out other duties and responsibilities as assigned, according to the requirements of education and experience contained in this document.   Qualifications: EDUCATION AND EXPERIENCE: Juris Doctor (JD) degree from an ABA accredited law school License to practice law in the state of Oklahoma with not less than two years’ experience     KNOWLEDGE, SKILLS AND ABILITIES: Superb analytical and organizational skills with ability to multi-task/simultaneously handle multiple projects and deadlines Superior oral and written communication skills Understanding of applicable federal and state laws, regulations and policies Research skills – ability to research complex legal/regulatory matters and provide recommendations/advice Excellent computer skills; experience with Microsoft Office (e.g., Word, Excel, Outlook) Ability to maintain a high-level of confidentiality Must be able to read, write, and speak in English. Experience in the insurance and healthcare industry (desirable)       WORKING CONDITIONS:  Current work environment is remote, however, some state exclusions apply. Must have access to a reliable and secured internet connection source. Work environment must maintain confidentiality of business information, including Protected Health Information (PHI), as required by HIPAA and company policy. This position will also be required to use reasonable and necessary safeguards to protect GlobalHealth records from unauthorized access, disclosure or damage and will adhere to all GlobalHealth privacy and security policies.     TRAVEL:                                                                                                                                             Occasional travel (some overnight) may be required.   Must have a valid Oklahoma driver’s license and be able to drive a car.     WORKING RELATIONSHIPS:                                                                                                             Reports directly to Legal Department. Interacts with all levels of employee and management staff.   Also interacts with delegated entities, agents, vendors, outside attorneys, and regulatory agency personnel.      

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