California Department of Managed Health Care
Plan Surveys Senior Lead Attorney (Telework)
California Department of Managed Health Care, Los Angeles, California, United States,
Job Description And DutiesThis position is eligible for full-time telework under Government Code 14200 for eligible applicants residing in California. Remote-centered teleworker employees may be required to report in person to headquarters and/or offsite events or locations, as determined by management, and will be required to utilize a shared workspace or “hotel” when working in the office.The Office of Plan Monitoring (OPM) is responsible for evaluating and ensuring health care service plan regulatory compliance, quality improvement, and network adequacy as related to provision of managed health care services. The Division of Plan Survey’s (DPS or Division) public health and legal professionals plan and conduct routine and non-routine evaluations of licensed health plans and review service delivery filings for legal adequacy in order to ensure enrollees receive appropriate, sufficient, and timely care. The DPS also conducts focused behavioral health investigations of full-service commercial health plans (and their contracted specialized behavioral health plans) regulated by the Department of Managed Health Care (DMHC).Under the general direction of the DPS Assistant Chief Counsel, the Attorney IV will work with broad discretion and independence, performing the most difficult, complex and sensitive legal work for the DMHC related to regulation and enforcement pursuant to the Knox-Keene Health Care Service Plan Act of 1975 (“Knox-Keene Act”, Health and Safety Code Section 1340, et seq.). In particular, the Attorney IV will conduct complex legal tasks related to evaluating health plan compliance for the purposes of enforcement action and identifying specified evidence, as set forth in Senate Bill 858, to justify recommended penalty levels assessed by DMHC against health plans and assist the DMHC's Office of Enforcement (OE) in obtaining any additional evidence or legal analysis necessary to support all enforcement referrals originating from DPS. The Attorney IV will also handle all aspects of complex surveys and act in a lead capacity over other attorneys in researching and resolving the most complex medical survey issues. Duties performed by the Attorney IV will include, but not be limited to:Participating in survey planning and coordination activities;Reviewing health plan documents;Reviewing the consultant's work product and performing complex legal analysis of the findings from the surveys;Making investigative inquiries and coordinating with the OE;Assisting with determining the legal justification for and participating or monitoring the assigned attorney’s work on a non-routine survey;Preparing, reviewing and editing reports of survey findings and memoranda concerning identified violations of applicable laws;Providing expert-level legal advice to both DPS and Department management and staff on rapidly-evolving issues in health care law;Periodically traveling to and working on-site at health plan facilities.You will find additional information about the job in the
Duty Statement .Working ConditionsThe DMHC utilizes a hybrid telework model to provide all employees with an avenue to telework while ensuring business and operational needs are met.Remote-Centered employees are expected to maintain a safe and distraction-free work environment at the approved alternate work location. Remote-Centered employees agree to adhere to the state telework policy, the DMHC's telework policy, and conditions cited in the Telework Agreement (STD 200).Office-Centered employees are expected to maintain a dedicated workstation at a DMHC official worksite. Office-Centered employees are expected to work in a climate-controlled office or cubicle under artificial lighting.Minimum RequirementsYou will find the Minimum Requirements in the Class Specification.ATTORNEY IVPosition DetailsJob Code #:
JC-404740Position #(s):
409-571-5780-014Working Title:
Plan Surveys Senior Lead Attorney (Telework)Classification:
ATTORNEY IV$11,644.00 - $14,954.00 A# of Positions:
1Work Location:
Sacramento CountyTelework:
TeleworkJob Type:
Permanent, Full TimeDepartment InformationThe mission of the California Department of Managed Health Care (DMHC) is to protect consumers’ health care rights and ensure a stable health care delivery system. The DMHC accomplishes its mission by ensuring the health care system works for consumers. The Department protects the health care rights of more than 29.7 million Californians by regulating health care service plans, assisting consumers through a consumer Help Center, educating consumers on their rights and responsibilities and preserving the financial stability of the managed health care system.DMHC values diversity at all levels of the organization and is committed to fostering an environment in which employees from a variety of backgrounds, cultures, and personal experiences are welcomed and can thrive. DMHC believes the diversity of our employees and their unique ideas inspire innovative solutions to further our mission. Join DMHC and help us improve the lives of all Californians.Special RequirementsThe position(s) require(s) a Background Investigation be cleared prior to being hired.All applicants not currently employed by the DMHC will be subject to a pre-employment background investigation. The investigation will consist of fingerprinting and an inquiry to the California Department of Justice to disclose criminal records.Application InstructionsCompleted applications and all required documents must be received or postmarked by the Final Filing Date in order to be considered. Dates printed on Mobile Bar Codes, such as the Quick Response (QR) Codes available at the USPS, are not considered Postmark dates for the purpose of determining timely filing of an application.Final Filing Date: 12/12/2023How To ApplyComplete Application Packages (including your Examination/Employment Application (STD 678) and applicable or required documents) must be submitted to apply for this Job Posting. Application Packages may be submitted electronically through your CalCareer Account at www.CalCareers.ca.gov.QualificationsStatement of QualificationsIn order to be considered for this position, you must submit the following Statement of Qualifications (SOQ) with your application. An SOQ is a narrative discussion describing how the candidate’s education, training, experience and skills meet the minimum and desirable qualifications for the position. The SOQ should also document each candidate’s ability to present information clearly and concisely in writing. The SOQ must be typewritten, use no less than Arial 12 point font, and be no more than two pages in length.The SOQ should address the following:Describe your understanding of the mission of the DMHC.Describe your experience, with regard to health care law, health care industry trends, and legislative and regulatory processes.Describe your experience serving as a lead attorney, subject matter expert and/or as a mentor to less-experienced attorneys.Describe your experience leading projects, and what leadership and organizational skills you have applied to ensure successful outcomes of your projects.Applicants that do not submit a SOQ with their application packet will automatically be disqualified from consideration for this position. Cover letters, resumes and applications will not take the place of this document.Equal Opportunity EmployerThe State of California is an equal opportunity employer to all, regardless of age, ancestry, color, disability (mental and physical), exercising the right to family care and medical leave, gender, gender expression, gender identity, genetic information, marital status, medical condition, military or veteran status, national origin, political affiliation, race, religious creed, sex (includes pregnancy, childbirth, breastfeeding and related medical conditions), and sexual orientation.
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Duty Statement .Working ConditionsThe DMHC utilizes a hybrid telework model to provide all employees with an avenue to telework while ensuring business and operational needs are met.Remote-Centered employees are expected to maintain a safe and distraction-free work environment at the approved alternate work location. Remote-Centered employees agree to adhere to the state telework policy, the DMHC's telework policy, and conditions cited in the Telework Agreement (STD 200).Office-Centered employees are expected to maintain a dedicated workstation at a DMHC official worksite. Office-Centered employees are expected to work in a climate-controlled office or cubicle under artificial lighting.Minimum RequirementsYou will find the Minimum Requirements in the Class Specification.ATTORNEY IVPosition DetailsJob Code #:
JC-404740Position #(s):
409-571-5780-014Working Title:
Plan Surveys Senior Lead Attorney (Telework)Classification:
ATTORNEY IV$11,644.00 - $14,954.00 A# of Positions:
1Work Location:
Sacramento CountyTelework:
TeleworkJob Type:
Permanent, Full TimeDepartment InformationThe mission of the California Department of Managed Health Care (DMHC) is to protect consumers’ health care rights and ensure a stable health care delivery system. The DMHC accomplishes its mission by ensuring the health care system works for consumers. The Department protects the health care rights of more than 29.7 million Californians by regulating health care service plans, assisting consumers through a consumer Help Center, educating consumers on their rights and responsibilities and preserving the financial stability of the managed health care system.DMHC values diversity at all levels of the organization and is committed to fostering an environment in which employees from a variety of backgrounds, cultures, and personal experiences are welcomed and can thrive. DMHC believes the diversity of our employees and their unique ideas inspire innovative solutions to further our mission. Join DMHC and help us improve the lives of all Californians.Special RequirementsThe position(s) require(s) a Background Investigation be cleared prior to being hired.All applicants not currently employed by the DMHC will be subject to a pre-employment background investigation. The investigation will consist of fingerprinting and an inquiry to the California Department of Justice to disclose criminal records.Application InstructionsCompleted applications and all required documents must be received or postmarked by the Final Filing Date in order to be considered. Dates printed on Mobile Bar Codes, such as the Quick Response (QR) Codes available at the USPS, are not considered Postmark dates for the purpose of determining timely filing of an application.Final Filing Date: 12/12/2023How To ApplyComplete Application Packages (including your Examination/Employment Application (STD 678) and applicable or required documents) must be submitted to apply for this Job Posting. Application Packages may be submitted electronically through your CalCareer Account at www.CalCareers.ca.gov.QualificationsStatement of QualificationsIn order to be considered for this position, you must submit the following Statement of Qualifications (SOQ) with your application. An SOQ is a narrative discussion describing how the candidate’s education, training, experience and skills meet the minimum and desirable qualifications for the position. The SOQ should also document each candidate’s ability to present information clearly and concisely in writing. The SOQ must be typewritten, use no less than Arial 12 point font, and be no more than two pages in length.The SOQ should address the following:Describe your understanding of the mission of the DMHC.Describe your experience, with regard to health care law, health care industry trends, and legislative and regulatory processes.Describe your experience serving as a lead attorney, subject matter expert and/or as a mentor to less-experienced attorneys.Describe your experience leading projects, and what leadership and organizational skills you have applied to ensure successful outcomes of your projects.Applicants that do not submit a SOQ with their application packet will automatically be disqualified from consideration for this position. Cover letters, resumes and applications will not take the place of this document.Equal Opportunity EmployerThe State of California is an equal opportunity employer to all, regardless of age, ancestry, color, disability (mental and physical), exercising the right to family care and medical leave, gender, gender expression, gender identity, genetic information, marital status, medical condition, military or veteran status, national origin, political affiliation, race, religious creed, sex (includes pregnancy, childbirth, breastfeeding and related medical conditions), and sexual orientation.
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