The Health Connector is seeking a General Counsel to run its legal department and manage its legal affairs. The General Counsel reports directly to the Executive Director and is responsible for overseeing a range of legal activities, including policy development, compliance, procurement and contracting matters, risk management, regulatory activity and administrative appeals. This is a full-time exempt position.
Key Responsibilities include:
- Manage a staff of lawyers, legal support personnel, compliance manager, human resources director, and an administrative appeals unit.
- Advise the Executive Director and senior management on all legal issues, including statutory and regulatory interpretation, contracting, ethics, governance and compliance.
- Interpret and apply federal and state laws governing health insurance exchanges, including the federal Affordable Care Act and the state’s Chapter 58, which established the Health Connector. Advise on policies and procedures designed to meet these legal requirements.
- Advise senior management on issues related to board governance, including development of board reports and communications, compliance with board bylaws, and observance of open meeting requirements.
- Advise on ethics issues, including development and monitoring of ethics policies, counseling on individual ethics questions, and conducting staff education and training.
- Oversee compliance activities, encompassing a range of legal requirements that include data management, data privacy and security, fraud prevention, and ethics. Compliance activities include interpreting governing statutes and regulations; developing and maintaining policies, procedures and internal controls; conducting training, investigating and responding to incidents of non-compliance; and advising on best practices and remediation.
- Provide legal support for outside financial and programmatic audits of the Health Connector.
- Ensure that Health Connector procurements are conducted in accordance with governing law and policy, and follow best practices.
- Draft, negotiate and interpret contracts with health insurance carriers, external vendors, other branches of government, and other third parties. Work with staff to interpret and conform to contractual requirements.
- Provide legal advice on Health Connector grant procedures, including the awarding of grants to eligibility and enrollment navigators.
- Oversee the Health Connector’s responsibility for enforcing minimum creditable coverage standards as established by state law. Responsibilities including drafting and interpreting regulations; overseeing the certification of health plans as MCC-compliant; and managing regulatory staff.
- Oversee the Health Connector’s role in adjudicating appeals of the individual mandate penalty, established by state law, which is imposed on residents who do not purchase health insurance if affordable and available. Responsibilities include drafting and maintaining Health Connector regulations regarding the individual mandate, including the procedures for obtaining exemptions or bringing administrative appeals; managing appeals staff and hearing officers; and monitoring appeals and exemption procedures and decisions.
- Ensure compliance with legal requirements governing the determination of eligibility, and other customer relations matters. Responsibilities including drafting and maintaining Health Connector regulations regarding eligibility and enrollment, including the procedures for bringing administrative appeals of eligibility decisions; managing appeals staff and hearing officers; and monitoring appeals procedures and decisions.
- Provide legal support on the design and implementation of eligibility determination and verification procedures, and noticing. Advise on the resolution of customer service or customer relations issues.
- Responsible for risk management, including conducting regular assessment of risk areas and developing and advising on best practices to avoid or minimize risk. Ensure Health Connector representation in any pending or threatened litigation. Respond to requests for information from regulatory or oversight agencies. Maintain insurance coverage to indemnify against range of business risks.
- Oversee the human resources function at the Health Connector. Responsibilities include developing and maintaining personnel policies and code of conduct; participating in employee training; interpreting laws regarding employment and personnel matters; developing procedures and policies to ensure compliance with such laws; advising managers on personnel matters; and working on resolution of personnel issues.
- Collaborate with Health Connector information technology staff on a range of issues arising from the Health Connector’s role as an internet-based e-commerce entity. Responsibilities include drafting, negotiating and advising on technology contracts with vendors or other third parties; implementing and monitoring data management, privacy protection, and security procedures; drafting and updating IT, data management, security and privacy policies; and overseeing risk assessments of privacy and security practices.
- Handle a variety of business related functions, including trademark registration and protection, leasing of premises, and annual financial disclosures.
- Maintain relations with legal departments of other government agencies in related fields, oversight agencies, and business partners.
Experience and Qualifications:
- Candidates must have a J.D. from an accredited law school and be licensed to practice law in Massachusetts.
- A minimum of 10 years of experience in active legal practice.
- Knowledge of health insurance and health care issues.
- Experience in government and public sector law.
- Familiarity and high level of comfort with technology, sufficient to advise on legal matters arising from Health Connector’s role as an internet-based e-commerce entity.
- Excellent communication skills, including written communications, public speaking, and presentations.
- Strong organizational and managerial abilities. Must be able to manage multiple responsibilities simultaneously.
- Ability to thrive in a complex, fast-paced environment.
- Familiarity with health insurance exchanges, administrative law.
- Experience with legal issues related to data privacy and security, particularly in the health care field.
- Experience in personnel management and/or employment law.
- Experience in risk management.
Work Setting: This position requires the employee to work on-site.
Salary: Salary range is competitive; salary will be commensurate with experience.
If interested: Send cover letter and résumé to Connectorfirstname.lastname@example.org.
Please note: Due to the requirement of 268A, please complete the Applicant Disclosure Form and return with your application.
About the Health Connector:
The Commonwealth Health Insurance Connector Authority (Health Connector) is an independent public authority serving as the Affordable Care Act (ACA)-compliant marketplace for the Commonwealth. The organization is charged with providing subsidized and unsubsidized health insurance to individuals and small employers. The Health Connector also oversees policy development related to health care reform under both state and federal laws, as well as conducting public education and outreach about health care reform and coverage opportunities.
The Health Connector is an equal opportunity employer that values diversity as a vital characteristic of its work force. We consider qualified applicants without regard to race, color, religion, gender, sexual identity, gender identity, national origin or disability.