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 legal services to the AHCCCS Office of Inspector General (AHCCCS OIG). AHCCCS OIG is responsible for reviewing suspected incidents of fraud, waste, and/or abuse. This includes the preliminary investigation of credible allegations of fraud, the preliminary and full investigation of fraud, waste, and/or abuse, and any other matters necessary to comply with the authority or obligations vested in AHCCCS OIG under State or Federal law, rule, regulations, or policies. This position has the potential to work in a Virtual Office (VO) setting or may Telecommute based on the needs of the unit and at the discretion of leadership.
• Perform legal research, provide legal advice, and prepare related legal documents consistent with state and federal law concerning the legal representation of the AHCCCS Office of the Inspector General. Without limitation, other subjects may include review of and preparation of comments on proposed federal regulations and state legislation, review of managed care contracts, interpretation and assistance with the drafting of State Plan amendments, draft Arizona Administrative Code rules.
• Negotiate and draft settlement agreements and correspondence relating to diverse contested matters including civil monetary penalties and eligibility fraud, payment suspensions for credible allegations of fraud, collection issues, provider terminations and suspensions and other matters.
• Coordinate, assist, and oversee work performed by outside counsel assigned to various litigation matters for the agency in various judicial and administrative proceedings regarding the administration of the program including but not limited to complex matters relating to recovery of program overpayments, civil penalties for provider and member fraud, credible allegations of fraud, termination and suspension of health care providers participating in the AHCCCS program.
• 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.
• Respond to discovery requests, subpoenas, and public records requests while ensuring compliance with state and federal privacy requirements.
• Review Administrative Law Judge Recommended Decisions and prepare Director Decisions and Final Decisions.
• Supervise professional staff, including attorneys and paralegals.
• Knowledge of:
* Health care fraud and/or the litigation of white-collar fraud matters
* AHCCCS programs, Medicaid, the Children's Health Insurance Program, and State-based behavioral health programs.
* Regulation of managed care delivery systems and health care provider reimbursement
* Rules of procedure related to judicial and administrative matters in complex litigation
* Processes and procedures relating to State and federal administrative rulemaking
* Public records and health information privacy
* Ethical standards applicable to lawyers and public employees
* Managerial and supervisory practices
* Writing/preparing complex documents/reports
* Extracting, utilizing relevant information and research authorities and applying them to complex facts
* Extracting relevant facts from exceedingly complex problems/cases/assignments
* Strong organizational and interpersonal skills
* Attention to detail and accuracy
* Effective negotiation skills
* Strong project management skills including project development, organization and prioritization
* Computer systems skills, including advanced Microsoft Office skills
* Preparing complex legal documents including pleadings, motions, discovery, affidavits or declarations
* Presenting cases and persuading administrative and judicial decision-makers through various stages of legal representation
• Ability to:
* Identify legal issues and develop strategies to reduce legal risk
* Effectively manage and resolve competing interests and perspectives
* Present legal positions clearly and logically in written and oral form
* Identify and perform analysis/synthesis of complex issues; present recommendations and reports
* Plan, prioritize and organize multiple projects and tasks
* Communicate complex issues verbally and in writing in a clear and concise manner
* Work effectively and professionally with AHCCCS, other state agency personnel and third parties
* Read and comprehend complex State and Federal laws and regulations and other requirements
* Work independently and with minimal supervision, including the preparation of correspondence, memos, pleadings and other papers
* Accurately complete complex assignments in a timely fashion
* Perform under pressure and short time frames as necessary
* Appropriately apply professional ethics rules into practice
• 3-7 years healthcare fraud, waste, and abuse experience, preferably involving Medicare/Medicaid healthcare finance
• Prior experience representing state or federal agencies
• White collar and/or financial and/or accounting fraud matters
• Juris Doctorate Degree from an accredited law school
• Licensed to practice law in Arizona and in good standing
At AHCCCS, we promote the importance of work/life balance by offering workplace flexibility and a variety of learning and career development opportunities. Among the many benefits of a career with the State of Arizona, there are 10 paid holidays per year, accrual of sick and annual leave, affordable medical benefits and participation in the Arizona State Retirement Plan.
For a complete list of benefits provided by The State of Arizona, please visit our benefits page
Persons with a disability may request a reasonable accommodation such as a sign language interpreter or an alternative format by contacting 602-417-4497.
Requests should be made as early as possible to allow time to arrange the accommodation. Arizona State Government is an AA/EOE/ADA Reasonable Accommodation Employer.
ARIZONA MANAGEMENT SYSTEM (AMS)
All Arizona state employees operate within the Arizona Management System (AMS), an intentional, results-driven approach for doing the work of state government whereby every employee reflects on performance, reduces waste, and commits to continuous improvement with sustainable progress. Through AMS, every state employee seeks to understand customer needs, identify problems, improve processes, and measure results.
State employees are highly engaged, collaborative and embrace a culture of public service.
Arizona State Government is an AA/EOE/ADA Reasonable Accommodation Employer.