WV Department of Health and Human Resources
Nature of Work
Under direct supervision of the General Counsel, serve as Lead Attorney for WV Bureau for Medical Services (BMS) MCO Program. This includes drafting and updating large MCO contract/agreements; being very familiar with all Federal MCO statutes, regulations, and guidance; providing legal research and advice on an ad hoc basis for BMS leadership and other staff related to managed care; engaging in written and telephonic correspondence with representatives from WV related to the MCO Program; attending regular conference calls and meetings with WV’s Medicaid MCO’s and WV MCO’s consulting and actuarial vendor and MCO broker; assisting WV BMS staff with all contract enforcement related actions against MCO’s such as corrective action plans; also serve as Lead Attorney for WV CHIP’s. CHIP is a separate unit within DHHR but housed under BMS. Perform legal research and advice as needed by BMS/CHIP leadership and other employees, including interpretation of Federal and State statutes and regulations, court cases and other guidance. Most research would be related to managed care but could extend into other Medicaid or CHIP related areas. Work with leadership on creating an annual legislative agenda and draft; review and communicate with legislative staff in support of the legislative agenda, mostly related to managed care. Perform other duties as required for legal support of BMS and CHIP; may include drafting and filing State Plan amendments for WV Medicaid Plan; responding to Freedom of Information Act (FOIA) requests; overseeing litigation in which BMS is involved; working on issues related to providers for BMS Medicaid; reviewing and advising on policy manual provisions; reviewing and approving procurement documents; working on Medicaid Waiver related documents. Other related duties as assigned.
Training: Graduation from a regionally accredited or American Bar Association accredited law school.
To apply for this job email your details to DHHRJobs@wv.gov