State of Colorado

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Legal Division Director

at State of Colorado

Posted: 7/9/2019
Job Status: Full Time
Job Reference #: 2500437
Keywords:

Job Description

Overall Job Objective

Department Information


 
STATE OF COLORADO RESIDENCY REQUIRED
 
The Department of Health Care Policy and Financing offers a competitive benefits package to include the Public Employees Retirement Account (PERA) , 401k/457, health/dental insurance options, 10 holidays, accrual of paid sick and vacation/annual time, flex place and flex time. The Department is also centrally located; offers affordable ECO passes; has a fitness center on-site; and a variety of discounts on services and products are available to state employees through the State of Colorado's Work-Life Employment Discount Program. The Department also encourages employees to take advantage of advanced education and offers reduced college tuition through CSU Global for their employees. This Department is a "Tobacco Free Workplace". For more information visit: https://www.colorado.gov/hcpf.

The Legal Division exists to support the legal and privacy issues of the Department. The Legal Division is responsible for maintaining the Protected Health Information database that houses information regarding powers of attorney and authorizations, and to identify and control the release of Department records and protect the civil and privacy rights of program recipients under federal and state law, and to evaluate legal issues in the administration of Department programs to ensure compliance with federal and state law.  As well, the Legal Division is responsible for reviewing client appeals and renders the final agency decision, and undertakes special projects to provide advice to senior management on the Department's compliance with federal and state law. The Division also provides legal advice and counsel on the Department's contracts and procurement activities

Description of Job

What You'll be Doing

  • Position is responsible for providing general legal counsel to department staff in all areas of the Department's statutory functions specifically: client appeals, Colorado Open Record Act (CORA) requests, Health Insurance, Portability and Accountability Act (HIPAA) issues, Americans with Disability Act matters, and regarding the coordination of benefits to ensure that Medicaid is the payer of last resort. 
  • Position will develop and lead department efforts to coordinate Medicaid benefits with other third party payers; guide and lead staff to improve efforts to avoid inappropriate Medicaid expenditures and to recover any inappropriate expenditures. 
  • Position acts as the primary liaison with the Attorney General on behalf of the department and must work closely with the Office of Attorney General to maintain clear lines of authority regarding legal responsibilities handled by the AG on behalf of the department.
  • Position provides leadership in the development of policies and interpretation of national program objectives regarding third party liability, trusts, and fraud and abuse.
  • Position requires strong leadership and managerial ability to supervise the HIPAA Privacy Officer, the Client Appeals Office, the CORA Coordinator, and the Benefits Coordination section.
  • The Department will rely on the unique technical expertise of this individual to guide the organization in decision-making that minimizes department risk and allows the Department to  remain compliant.
  • This point person will represent the agency in negotiating business associate agreements as well as investigating privacy breach violations and arguing, defending, and or justifying the agencies' policies and practices related to privacy, HIPAA and ADA. 
  • The position will be the point person interacting with various federal agencies responsible for enforcement of the Social Security Act, HIPAA, and the ADA. 
  • In addition the position will offer guidance relating to pending and proposed legislation affecting the Department's programs.

Minimum Qualifications, Substitutions, Conditions of Employment & Appeal Rights

MINIMUM QUALIFICATIONS

Education and Experience:

Graduation from an accredited college or university with a bachelor's degree in health care administration, business administration, public administration and a juris doctor degree; and
  • Six (6) years of professional experience in the following areas:
    • Three (3) years experience in Medicaid law, or Medicare, or Health Plan, interpreting and analyzing state and federal statutes and regulations, including experience in federal reimbursement regulation, health care delivery systems, managed care purchasing, contracting and budgeting,
    • Two (2) years supervision of professional level staff, and
    • One (1) year of professional public or business administration experience which included establishing goals, objectives and developing/managing a budget to achieve program goals and objectives.
Included in the (6) six years of professional experience must be the following;
  • Must have experience analyzing state and federal statutes and regulations.
  • Must have excellent writing and oral communications skills. Prefer general knowledge of ADA issues, and HIPAA compliance in the protection of client health information.

This experience MUST be clearly explained in your employment history of the online application.

Substitutions:
A combination of professional work experience, which provided the same kind, amount and level of knowledge acquired in the required education, may be substituted on a year-for-year basis for the bachelor's degree.  A master's degree from an accredited college or university in Public Health, Public Policy, Health Care Administration, or other closely related field may be substituted for the bachelor's degree and one year of general experience.
There is no substitution for the Juris Doctorate or law license.

DEFINITION OF PROFESSIONAL EXPERIENCE:  Work that involves exercising discretion, analytical skill, judgment, personal accountability, and responsibility for creating, developing, integrating, applying, and sharing an organized body of knowledge that characteristically is uniquely acquired through an intense education or training regimen at a recognized college or university; equivalent to the curriculum requirements for a bachelor's or higher degree with major study in or pertinent to the specialized field; and continuously studied to explore, extend, and use additional discoveries, interpretations, and application and to improve data, materials, equipment, applications and methods. 


CONDITIONS OF EMPLOYMENT:

  • All positions at HCPF are security sensitive positions and require that the individuals undergo a criminal record background check as a condition of employment.
  • A current license to practice law in the State of Colorado is required.
  • Employees who have been disciplinarily terminated, resigned in lieu of disciplinary termination, or negotiated their termination from the State of Colorado must disclose this information on the application.

APPEAL RIGHTS:
If you receive notice that you have been eliminated from consideration for the position, you may protest the action by filing an appeal with the State Personnel Board/State Personnel Director within 10 days from the date you receive notice of the elimination. 

Also, if you wish to challenge the selection and comparative analysis process, you may file an appeal with the State Personnel Board/State Personnel Director within 10 days from the receipt of notice or knowledge of the action you are challenging. 

Refer to Chapters 4 and 8 of the State Personnel Board Rules and Personnel Director's Administrative Procedures, 4 CCR 801, for more information about the appeals process. The State Personnel Board Rules and Personnel Director's Administrative Procedures are available at www.colorado.gov/spb

A standard appeal form is available at: www.colorado.gov/spb. If you appeal, your appeal must be submitted in writing on the official appeal form, signed by you or your representative, and received at the following address within 10 days of your receipt of notice or knowledge of the action: Colorado State Personnel Board/State Personnel Director, Attn: Appeals Processing, 1525 Sherman Street, 4th Floor, Denver, CO 80203. Fax: 303-866-5038. Phone: 303-866-3300. The ten-day deadline and these appeal procedures also apply to all charges of discrimination.

Supplemental Information

Applicants are encouraged to attach a cover letter and resume to their application. 
 
Please note that ONLY your State of Colorado job application will be reviewed during the initial screening; if you submit a resume and cover letter, they will be reviewed in later stages of the selection process.  Therefore, it is paramount that you clearly describe all of your relevant experience on the application itself.  Applications left blank or marked "SEE RESUME" will not be considered.
 
Your application will be reviewed against the minimum qualifications for the position.  If your application demonstrates that you meet the minimum qualifications, you will be invited to the comparative analysis process, which is described below.
  
Comparative Analysis Process
 
The comparative analysis process will consist primarily of a review of applications against the minimum and preferred qualifications of this position. Applications will be reviewed in comparison to all others in the applicant pool in order to identify a top group of up to 6 candidates who may be invited for a final interview. Depending on the size of the applicant pool, additional selection processes may be utilized to identify a top group of candidates.  Applicants will be notified of their status via email.

Failure to submit properly completed documents by the closing date of this announcement will result in your application being rejected.

ADAAA Accommodations: Any person with a disability as defined by the ADA Amendments Act of 2008 (ADAAA) may be provided a reasonable accommodation upon request to enable the person to complete an employment assessment. To request an accommodation, please contact the person listed on this announcement by phone or email at least five business days before the assessment date to allow us to evaluate your request and prepare for the accommodation. You may be asked to provide additional information, including medical documentation, regarding functional limitations and type of accommodation needed. Please ensure that you have this information available well in advance of the assessment date.


~THE STATE OF COLORADO IS AN EQUAL OPPORTUNITY EMPLOYER~