Position Description: This position primarily provides legal counseling in the areas of TRICARE (the health care program for uniformed service members, retirees, and their families) and Commercial Health Plans (Small and Large Group and Individual). This position supports both the Legal Department's Government Programs Practice Group and Health Plan and Payor Operations Practice Group. This is a broad regulatory practice supporting Kaiser Permanente’s operations as an integrated delivery system in California and the eight other jurisdictions where Kaiser Permanente operates. The position will also work closely with colleagues supporting Provider Operations, Medicare, FEHBP, and other practice areas, as well as with colleagues supporting other Kaiser regions.
Provide legal regulatory and business counseling support related to Kaiser’s participation in TRICARE.
Serve as a subject matter expert and educational resource on all aspects of TRICARE for business leaders and colleagues.
Advise Health Plan leadership regarding Commercial Health Plan regulatory and operational matters, including but not limited to, federal and state payor regulation and compliance, new product development and design, employer group agreements, health care reform, member contracts and benefits, financial and regulatory examinations and filings, regulatory enforcement matters, HIPAA privacy and security matters, wellness programs and support for the provision of administrative services to self-funded plans.
A minimum 8 years of regulatory health care law experience, including a minimum of 3 years of Commercial Health Plan and/or TRICARE.
Active membership in the California or Maryland bar (as applicable) (or membership within 1 year from date of hire).
Juris Doctorate required.
Successful candidate will have a working knowledge of TRICARE (including direct and purchased care) and Commercial Health Plans, including individual, small and large group.
Superior writing and analytical skills based on substantial experience advising Managed Care Organizations, TRICARE managed care support contractors, and/or government agencies that administer or regulate services provided to TRICARE or commercial coverage enrollees.
Experience providing interpretation and analysis of statutes, regulations and sub-regulatory guidance.
Solid work ethic, excellent interpersonal and communication skills (written and verbal), and sharp analytical skills.
Ability to work independently and to work collaboratively as part of a team.
In addition to the above, experience in one or more of the following areas is a plus: recent TRICARE managed care support contractor procurements; ERISA; Affordable Care Act; Federal Employee Health Benefits Program: pricing and underwriting; Government reporting and audits.
Law Firm experience is a plus.
Primary Location: Oakland, CA, Pasadena, CA, or Rockville, MD.
Internal Number: 110193
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