Description:
Job summary:
The Office of Administrative Legal Services (OALS) is looking for a highly motivated individual to join our team as a Deputy General Counsel. This position will focus on providing a wide range of legal services to the agency with a focus on the Office of Inspector General generally, in administrative hearings and judicial proceedings, and as impacted by cross divisional issues. Major duties and responsibilities include but are not limited to:
  • Perform legal research, provide legal advice, and prepare related legal documents (contracts, intergovernmental agreements, operational protocols, and agency policies) consistent with state and federal law regarding all aspects of the administration of the program with an emphasis on providing advice to the AHCCCS Office of the Inspector General regarding provider and member fraud, provider participation, collections, and program integrity efforts.
  • Negotiate and draft settlement agreements and correspondence relating to diverse contested matters including civil monetary penalties for fraudulent claims and eligibility fraud, credible allegations of fraud, provider claim disputes, collection issues, and other matters
  • Supervise professional staff, including attorneys and paralegals
  • Coordinate efforts with the Medicaid Fraud Control Unit of Office of Arizona Attorney General and other State/Federal law enforcement entities such as the United States Attorney's Office and County Attorneys' Offices on issues related to the administration of the program including but not limited to matters relating to health care providers participation and civil penalties, credible allegations of fraud, and criminal prosecutions for provider and member fraud. Coordinate, assist, and oversee work performed by outside counsel assigned to various litigation matters for the agency.
  • Represent the Agency in various judicial and administrative proceedings regarding the administration of the program including but not limited to complex matters relating to civil penalties for provider and member
  • Respond to discovery requests, subpoenas, & public records requests while ensuring compliance with state & federal privacy requirements.
  • Review of proposed state and federal statutes and regulations affecting the program and advise the administration and Governor's Office on potential impacts. Assist with the drafting of formal administrative rules and policy consistent with program requirements and agency objectives.
  • Perform review and analysis of trusts associated with applications for benefits for compliance with legal and program requirements. Approve or deny trusts pursuant to 42 U.S.C 1396p, recommending amendments to trust in order to qualify for program eligibility and providing oversight of trust reviews.
  • Review Administrative Law Judge Recommended Decisions & prepare Director Decisions & Final Decisions.

Knowledge, skills and abilities (ksas):
  • Demonstrated knowledge of health care compliance
  • Demonstrated knowledge of regulations of managed care delivery systems and health care provider reimbursement
  • Strong ability to read and comprehend complex State and Federal laws and regulations and other requirements; extract relevant facts from exceedingly complex problems/cases/assignments; write/prepare complex reports and legal documents including pleadings, motions, discovery, affidavits or declarations;
  • Must possess effective negotiation skills
  • Skilled in attention to detail and accuracy
  • Strong organizational and interpersonal skills and ability to work effectively and professionally with AHCCCS, other state agency personnel and third parties
  • Managerial and supervisory practices

Selective preference(s):
  • Must have Juris Doctorate degree from an accredited law school
  • Must be licensed to practice law in Arizona and in good standing
  • Experience in prosecution or defense of False Claims Act, Healthcare fraud, white collar crime and/or similar matters involving fraud, waste, and abuse preferred

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