Senior Counsel - Healthcare/Regulatory

Company :

Highmark Health

Job Description :

JOB SUMMARY

*This role is hybrid (T/W/Th) in our Pittsburgh Office

This job investigates factual situations and presents well-reasoned and creative solutions and alternatives based upon independent legal research and analysis of the facts and the law. The incumbent provides timely and accurate legal advice and prepares effective documents based upon knowledge of federal, state and other applicable law and the regulatory environment in which the Corporation and its affiliates (“Corporation”) function. A senior position held by a lawyer with advanced legal skills and a track record evidencing the ability to deliver and/or oversee the delivery of business-oriented, effective and efficient legal services, project management, and strategic counseling on significant projects or matters for one or more discrete units of the Corporation. Expected to have deep knowledge of the Corporation’s business, while retaining the discipline of legal analysis; will anticipate and address internal / external business issues and recommend best practices. Works cooperatively with both inside counsel and outside legal counsel.

ESSENTIAL RESPONSIBILITIES

• Provide regular legal support for one or more discrete units of the Corporation; demonstrate deep knowledge of the Corporation’s business, while retaining the discipline of legal analysis; interpret law and apply to internal / external business issues and recommend best practices; provide timely, accurate, comprehensive, thorough and practical legal advice and prepare effective documents based upon knowledge of federal, state and other applicable law and the regulatory environment in which the Corporation functions; apply sound business judgment to the provision of legal advice; have highly advanced expertise in areas of legal practice that are necessary to effectively provide legal counsel; is viewed as a subject matter expert; provide results of analysis to other attorneys in the Law Department (“Department”) or directly to appropriate management and staff of the Corporation; provide legal advice to management and staff of the Department.
• Maintain positive, responsive, consistent and effective relationships with other members of the Department, as well as management and other staff of the Corporation, and teams of inside / outside counsel; mentor attorneys and paralegals; educate internal customers on legal issues; maintain and foster productive relationships between the Corporation and external parties.
• Manage litigation, transactions or other matters and/or assist and work cooperatively with and/or supervise outside legal counsel, including outside lawyers from approved law firms used by the Corporation; may direct such work of outside legal counsel or facilitate such work of outside counsel to address issues effectively and efficiently, including minimizing outside legal counsel fees and expenses, as appropriate.
• Have excellent skills in preparing precise, thorough and responsive legal memoranda, contracts, pleadings, analyses, correspondence and other relevant documents; perform legal research and investigate facts; exhibit a strong attention to detail and work ethic; able to handle complex legal matters or projects independently.
• Should have excellent decision-making capability and should be highly proficient in being able to make business-oriented yet legally compliant recommendations.
• Investigate highly complex situations and present well-reasoned, broad perspective, innovative and creative solutions and alternatives based upon independent legal research and analysis of the facts and the law.
• Ability to easily engage in two-way communication and solicit and accept feedback.
• Excellent negotiating skills with outside parties.
• Able to juggle multiple matters and effectively multi-task and prioritize tasks to ensure that work is completed in a timely, thorough, comprehensive and efficient manner.
• Will work through goals and objectives despite changing priorities and demonstrate the willingness to do things differently.
• Will seek out challenging tasks and assignments, engage in frequent development discussions, set his/her own career goals and development plans and execute against them; is open to feedback and effectively adapts / changes as a result of such feedback.
• Other duties as assigned or requested.

EDUCATION

Required

• Juris Doctorate

Substitutions

• None

Preferred

• None

EXPERIENCE

Required

• 10 years of elated, progressive law experience that is deeper in the area of relevant specialization.
• 7 years in related disciplines, such as insurance regulation, health law, general corporate law, mergers and acquisitions, contracts, antitrust, employee benefits, intellectual property and litigation

Preferred

• None

LICENSES or CERTIFICATIONS

Required

• License to practice law in the Commonwealth of Pennsylvania or applicable state (DE, WV or NY); or eligible for admission within one year of hire

• For Privacy Counsel positions only: Obtain and maintain certification as a privacy professional within one year of employment

Preferred

• 3+ years experience with Fraud, Waste and Abuse
• 3+ years Patient legal resolution
• Healthcare research and resolution
• Regulatory, Managed Care and Reimbursement

SKILLS

• Strong written and oral communication skills
• Strong relationship building skills
• Client focused with strong business acumen
• Self-starter with the ability to work under pressure independently and as part of a team
• Ability to think strategically and act proactively to create strong trust and confidence with business units
• Strong innovative problem-solving capabilities
• Keep current on recent developments in the law and develop in-depth knowledge of one or more areas of the law which are applicable to the Corporation’s business
• Observe high standards of confidentiality consistent with all applicable laws, professional standards and requirements of the Corporation
• Observe high personal and professional ethics

Language (Other than English):

None

Travel Requirement:

0% - 25%

PHYSICAL, MENTAL DEMANDS and WORKING CONDITIONS

Position Type

Office-based

Teaches / trains others regularly

Occasionally

Travel regularly from the office to various work sites or from site-to-site

Rarely

Works primarily out-of-the office selling products/services (sales employees)

Never

Physical work site required

Yes

Lifting: up to 10 pounds

Constantly

Lifting: 10 to 25 pounds

Occasionally

Lifting: 25 to 50 pounds

Rarely

Disclaimer: The job description has been designed to indicate the general nature and essential duties and responsibilities of work performed by employees within this job title. It may not contain a comprehensive inventory of all duties, responsibilities, and qualifications required of employees to do this job.

Compliance Requirement : This job adheres to the ethical and legal standards and behavioral expectations as set forth in the code of business conduct and company policies.



As a component of job responsibilities, employees may have access to covered information, cardholder data, or other confidential customer information that must be protected at all times. In connection with this, all employees must comply with both the Health Insurance Portability Accountability Act of 1996 (HIPAA) as described in the Notice of Privacy Practices and Privacy Policies and Procedures as well as all data security guidelines established within the Company’s Handbook of Privacy Policies and Practices and Information Security Policy.

Furthermore, it is every employee’s responsibility to comply with the company’s Code of Business Conduct. This includes but is not limited to adherence to applicable federal and state laws, rules, and regulations as well as company policies and training requirements.

Highmark Health and its affiliates prohibit discrimination against qualified individuals based on their status as protected veterans or individuals with disabilities and prohibit discrimination against all individuals based on any category protected by applicable federal, state, or local law.

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