Managed Care Provider Relations Manager jobs in Oakland, CA

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Position Base
Oakland

Location
UCOP - Franklin Building

UC OFFICE OF THE PRESIDENT

At the University of California (UC), your contributions make a difference. A world leader producing Nobel and Pulitzer prize recipients with over 150 years of groundbreaking research transforming the world. Choose a career where you can leverage your knowledge, skills and aspirations to inspire and support some of the greatest minds in the world, and those who will follow in their footsteps. Working at the University of California is being part of a unique institution, and a vibrant and diverse community. At the University of California, Office of the President, we propel our mission through impactful work locally, in government centers and systemwide. We are passionate people, serving the greater good.

The University of California, one of the largest and most acclaimed institutions of higher learning in the world, is dedicated to excellence in teaching, research and public service. The University of California Office of the President is the headquarters to the 10 campuses, six academic medical centers and three national laboratories and enrolls premier students from California, the nation and the world.

DEPARTMENT OVERVIEW

UC Legal - Office of the General Counsel (UCL) provides legal services to the University, including representation, advice, research and training. We also provide legal opinions to the Board of Regents, administration, faculty, staff and others acting on the university's behalf. We report jointly to the Board of Regents and the President.

POSITION SUMMARY
Reporting to the Managing Counsel, Health Affairs, Privacy & Data Protection, the Principal Counsel - Managed Care provides primary legal support to the University's health enterprise on managed care issues. Duties include advising on material managed care transactions including high-impact health plan contracts with the University's medical centers as well as administrative contracts between health plans and the University's employer group or student health plans; providing strategic guidance on managed care issues including innovative payment methodologies; advising on managed care regulatory issues including Knox-Keene Act licensure and other requirements; and acting as the subject-matter expert on managed care issues including privacy and fraud and abuse laws involving health plans, as well as rules related to Accountable Care Organization and other innovation models. The position is relied on to represent institutional concerns persuasively to internal and external parties and serves as the lead legal counsel contact on managed care issues and interacts frequently with the members of the UC Procurement Services, UC Health, and Human Resources teams in the Office of the President, the medical center or campus teams responsible for managed care and employer group or student health plans, as well as medical center Chief Financial Officers.

The Principal Counsel - Managed Care should be a strategic thinker, an approachable adviser, and a strong relationship builder who thrives in a challenging environment and is clearly aligned with the University's and UCL's values.

Responsibilities

90% Core Legal Work

• Supports UC Legal's Health Affairs, Privacy and Data Protection Group's coordination efforts to facilitate more efficient, effective, and consistent delivery of health law services system-wide.
• Provides substantial expertise within the University in the Health Law field, particularly in managed care transactional, strategic, licensure, regulatory and litigation issues and issues related to managed care such as privacy or fraud and abuse laws related to managed care entities or employer or student health plans.
• Under general direction handles independently a full range of legal matters and projects, to include those of high complexity and of substantial importance and impact.
• Regularly counsels and advises senior management in the UC health enterprise, often on issues that can have significance across the system.
• Provides high-level strategic advice to University business units, including practical advice and alternative solutions to business concerns.
• Collaborates to achieve solutions on the most complex legal issues in area of specialty, providing strategic direction with high level stakeholders such as the medical center CFOs, and senior procurement and health administrators at Office of the President and/or across UC locations.
• Provides actionable and practical advice based on sophisticated interpretation of facts and law in areas of ambiguity. Identifies and frames systemic legal issues, and formulates and proposes strategic approaches to address them which can have broad impact across the UC system.
• Participates on external committees to provide input on issues that affect state and/or federal policy. Keeps informed on changing legislation and case law developments affecting overall operations of the University as they relate to health care transactions.
• Provides training as well as client advisories and tools related to such developments.
• Directly negotiates matters on behalf of The Regents.
• Acts as a liaison with outside counsel.
• May provide strategic support and expertise on litigation matters in areas of expertise.
• Recognizes strategic needs of organization and proactively builds relationships with appropriate stakeholders to ensure successful outcomes.
• Establishes effective relationships with key internal and external constituencies.
• Mentors law clerks, fellows, and other learners.

10% Leadership

• Functions as lead and technical resource and provides functional advice, training and/or guidance to clients or to less-experienced attorneys.
• Develops objectives and ensures service according to established priorities.
• Ensures accurate record keeping in compliance with OGC data quality protocols.
• Complies with delegations of authority for committing University funds.
• Practices OGC's established Values for Principles of Community: collaborative, supportive, respectful of differences, and committed to fairness and diversity in all interactions, both within and outside the team.
• Supports OGC's commitment to diversity efforts - ensures equal opportunity in recruitment process by ensuring diverse representation on search committees and outreach efforts. Promotes equity in advancements and encourages participation in career advising or mentoring programs.

Required Qualifications

• Minimum of 7 years of progressively responsible experience advising clients on high-level managed care transactional, regulatory and/or licensing matters.
• Managed care experience gained in a law firm, or in-house counsel for an academic institution, provider, managed care entity and/or government regulator.
• Significant experience advising executives on sophisticated and often highly complex managed care matters with minimal preparation time and providing both strategic and practical advice.
• Deep understanding of California managed care market.
• Experience working with relevant regulators such as the Department of Insurance and Department of Managed Healthcare.
• Health law expertise including a sufficient understanding of applicable laws, industry practices, and enforcement trends to identify, assess, mitigate and resolve legal risks associated with Medical Center and Medical School activities, or a willingness to develop such expertise. In depth abilities in collaboration, facilitation, and strategic and creative thinking.
• In-depth understanding of highly complex legal issues and ability to foresee implications of different approaches or actions, even when ambiguous or hidden.
• Advanced interpersonal communication skills, including proven ability to actively listen, negotiate, persuade and educate.
• Skills to gain trust and build credibility with a broad group of colleagues and clients, to include senior leaders.
• Advanced written communication skills and ability to create and deliver effective materials and/or presentations appropriate to a particular audience.
• Advanced research skills; ability to readily identify critical legislative changes in area of specialty.
• In depth decision making ability, even when unpopular, earning credibility and support from colleagues.
• Advanced skills in project management, and facilitating policy review and changes.
• Developing ability to mentor and coach all levels of staff; provide for succession planning in area of specialty.
• Proven ability to maintain confidentiality and exercise discretion and tact when handling sensitive or potentially sensitive issues.
• Demonstrated commitment to the highest ethical standards.

Preferred Qualifications

• Expertise in one or more of the following areas: Managed care issues for provider clients, privacy or fraud and abuse related rules applicable to managed care entities or employer or student health plans, and/or managed care litigation and reimbursement related issues. Innovative payment models (such as Accountable Care Organizations) and/or risk sharing or other innovative payment methodologies. ERISA and/or TRICARE.

Education: Advanced degree in related area is required

License/Certifications: Must be in good standing in the California State Bar or admitted within one year of employment. CURRENT ADMISSION IS STRONGLY PREFERRED. California's Registered In-House Counsel program is NOT available to University of California attorneys.

Travel Requirements: 10% Travel to medical centers, as needed

SPECIAL CONDITIONS

The person hired will be required to reside within California and report to work on-site at UC's Office of the President (UCOP) located in Oakland, CA on a regular basis. Current policy requires that a new employee work on-site at least two days a week on Tuesdays and Wednesdays ("anchor days"). In rare circumstances, approved by the General Counsel, candidates residing in or willing to relocate to California may be considered for a fully remote work arrangement.

SALARY AND BENEFITS

Job Title: Counsel 4
Job Code: 000201
Salary Grade: Grade 29

Payscale: $220,000 - $255,000, commensurate with experience
Full Salary Range: $165,200 - $333,800

The University of California, Office of the President, is required to provide a reasonable estimate of the compensation range for this role. This range takes into account the wide range of factors that are considered in making compensation decisions including but not limited to experience, skills, knowledge, abilities, education, licensure and certifications, and other business and organizational needs. It is not typical for an individual to be offered a salary at or near the top of the range for a position. Salary offers are determined based on final candidate qualifications and experience. The full salary range shows the growth potential for this position and the pay scale is the budgeted salary or hourly range that the University reasonably expects to pay for this position. Benefits: For information on the comprehensive benefits package offered by the University visit:

ADDITIONAL INFORMATION

HOW TO APPLY

Please be prepared to attach a cover letter and resume with your application.

APPLICATION REVIEW DATE

The first review date for this job is January 2, 2024. The position will be open until filled.

CONDITIONS OF EMPLOYMENT

Background Check Process: Successful completion of a background check is required for this critical position.

Smoke Free Work Environment: The University of California, Office of the President, is smoke & tobacco-free as of January 1, 2014.

As a condition of employment, you will be required to comply with the University of California , as may be amended or revised from time to time. Federal, state, or local public health directives may impose additional requirements.

EEO STATEMENT

The University of California, Office of the President, is an Equal Opportunity/Affirmative Action Employer. All qualified applicants will receive consideration for employment without regard to race, color, religion, sex, sexual orientation, gender identity, national origin, disability, age or protected veteran status.

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