Health Care/Counsel/In House/Detroit, Michigan

Company Name:
Associate General Counsel
Duties: Will report to Vice President of Legal. Will be responsible for managing CMC?s affairs related to litigation, contracts, and regulation. Will also provide guidance on matters related to compliance and offer input on the decision whether to send matters to outside counsel and oversee outside counsel as necessary. Oversee all ongoing activities related to the development, implementation, maintenance of, and adherence to the organization's privacy and confidentiality policies and procedures. Ensure that member health information created or maintained at company is protected in compliance with federal and state laws and company's information privacy practices. Consult with the CMC Executive team, advisors, tax attorneys, accountants and other necessary outside vendors. Coordinate and manage outside counsel and litigation. Appear in court of law and/or arbitration on behalf of the company. Negotiate and draft contractual agreements, such as real estate leases and advising on employment matters. Assist with the compliance program taking appropriate steps to improve its effectiveness. Develop and monitor methodologies and systems to build compliance awareness into daily business processes. Review and resolve corporate governance issues. Keep informed of insurance regulations and ensuring that appropriate strategies are in place. Develop, initiate, maintain and revise policies and procedures necessary for the operation of the MHP related activities. Annually review and update as necessary the CMC Code of Conduct to ensure that employees receive current and relevant guidance with respect to corporate compliance expectations. Work with human resources to ensure that each employee annually signs a Code of Conduct certification. Assist the General Counsel in resolving situations of alleged violations of rules, regulations, policies, procedures or standards of conduct by evaluating or recommending the initiation of investigative procedures and oversees the uniform handling of violations including any sanctions for plan employees. Ensure proper reporting of fraud, waste and abuse violations or suspected violations to the appropriate enforcement agencies including DCH. Acting member of the CMC Corporate Fraud, Waste and Abuse Committee and works with the committee. Identify potential areas of compliance vulnerability and risk. Develop and implement corrective action plans to resolve problematic issues. Provide general guidance on how to avoid or deal with similar situations in the future. Perform periodic reviews of departments. Assist with the development of training materials and programs for members, providers and plan employees and ensure that all employees receive training on corporate compliance. nsure that all employees are aware of both corporate and confidential mechanisms for reporting suspected fraud, waste and abuse. Prepare an annual report to the Quality Management Committee and the company's Board of Directors that summarizes CMC?s Fraud, Waste, and Abuse monitoring and detection activities and any policy or process changes made to enhance compliance. Anticipate potential legal problems within the organization and develop strategies to avoid litigation and reduce potential areas of risk. Perform other duties as assigned. Cooperate with the Office of Civil Rights, other legal entities, and organization officers in any compliance reviews or investigations. Perform other duties as assigned.

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