This role directs the legal affairs and risk management for the organization, providing legal counsel and support to all departments. It addresses legal and compliance issues, including regulatory, statutory, insurance, corporate governance, privacy, and healthcare laws like Medicare and Medicaid. The General Counsel ensures the organization's legal rights are protected by applying broad familiarity with major legal disciplines such as business transactions, corporate governance, employment, healthcare, licensing, intellectual property, risk management, and litigation. As a member of the management team, this position is actively involved in company operations and supports strategic objectives.
Responsibilities
Develop, implement, evaluate, and recommend best practices to ensure effective work processes and systems, maximize operating efficiencies, and increase the value of services provided
Direct and manage outside counsel/litigation resources as necessary and assist with resolving legal-related disputes
Research, review, analyze, interpret, draft, negotiate, approve, and/or direct the processing of various complex legal and compliance documents
Research and perform detailed analysis of legal and compliance matters, including interpreting and advising regarding current and proposed laws and regulations to determine impacts to the organization
Review, interpret, draft, and negotiate contracts, including business associate agreements, administrative service agreements, service agreements with vendors, software licensing agreements, and other general commercial business transactions
Research, provide legal opinions, and draft documents relative to regulatory filings with respect to policy forms, rates, agent and entity licensing and maintenance, consumer inquiries, and advertising materials
Assist with and/or monitor the development and compliance of insurance forms, including policies, contracts, summary plan descriptions, certificates of benefits, and other product-related documents, and ensure governmental and regulatory approval in the appropriate jurisdiction
Prepare corporate documents as necessary
Direct the Legislative Agenda and serve as the primary liaison
Monitor legislation and track government issues that could affect the company
Proactively research policies and trends that might impact the company in the future
Maintain a working knowledge of relevant issues, laws, regulations, and requirements related to the compliance program, including regulations and guidance under HIPAA, Medicare, Medicaid, and other insurance programs
Participate in establishing and providing compliance education, training, and awareness programs for employees, providers, and contractors
Facilitate, coordinate, and cooperate with auditing activities by outside agencies and internal departments that affect the corporate compliance program
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Investigate, track, and make recommendations regarding inquiries or complaints received from external regulatory agencies
Prepare responses to subscriber and provider complaints filed with state insurance departments and other regulatory and administrative agencies, as well as respond to subpoenas and other document requests
Assist with implementing regulatory, legislative, and contractual requirements, specifically developing, initiating, maintaining, and revising policies, procedures, and reporting for the general operation of the legal department
Develop, maintain, and update legal systems and records
Assist with Board-related activities, including corporate governance, maintaining corporate records, and preparing for, attending, and taking board minutes at meetings as needed
Complete corporate and regulatory filings, renewals, and reports
Manage and oversee various programs under legal affairs and enterprise risk management, including Audits (SOC 1 and 2, DDPA, Groups, EUTF, etc.), Insurance Renewals, Contract/Vendor Management, and Policies & Procedures Management
Supervise/Manage the Paralegal/Risk Management Analyst staff, including planning, organizing, training, motivating, and evaluating staff, making hiring and termination decisions, assigning work, developing growth opportunities, conducting performance evaluations, and taking corrective action
Communicate and assure that employees have a clear understanding of performance expectations and responsibilities
Plan, direct, and manage toward effective and appropriate activities and ensure satisfactory performance of employees
Develop and manage annual budget in alignment with company goals and objectives
Develop long and short-term strategic plans concerning the successful operation of the Legal department
Develop, implement, evaluate, and effectively communicate goals and responsibilities in alignment with company-wide objectives and goals
Contribute to the Executive
Develop company goals and standards, and monitor and report selected company goals and standards
Develop, implement, and enforce departmental policies and procedures and ensure initial and recurrent training occurs
Manage, implement, and enforce the Records Retention Program
Plan, direct, and manage the activities related to the department, monitoring productivity and performance while ensuring professionalism, quality, timeliness, and accuracy
Function as a legal liaison for outside counsel, DDPA, and federal and state law enforcement
Function as a compliance and internal audit liaison for outside counsel, DDPA, federal and state law enforcement, and external auditors
Perform other related duties as required or assigned by the President & CEO
Requirements
Juris Doctorate from an accredited law school
Hawaii State Bar admission required, or within two years of employment date if relocating
Minimum of ten (10) years of legal experience, including five (5) years of experience as in-house counsel
Minimum of two (2) years of experience managing staff
Ability to handle confidential and sensitive issues and materials
Ability to assess, develop, and implement programs, policies, and procedures
Detail-oriented with strong analytical, research, problem-solving, and reasoning skills
Excellent organizational skills and ability to handle multiple tasks
Nice to have:
Experience with Healthcare laws and regulations including Medicaid, Medicare, HIPAA, and Hawaii laws and regulations
Important Details
Team: Direct Reports: 1 Paralegal/Risk Management Analyst
About the Company
This position also functions in a similar capacity for Hawaii Client Services (HCS).