General Counsel/Chief Compliance Officer

Overview

This role is for a General Counsel/Chief Compliance Officer serving as the chief legal officer and a member of the Executive Team. The position provides comprehensive legal and compliance oversight for a managed care organization serving 46 counties in North Carolina. The organization manages services for individuals with serious mental health needs, substance use disorders, traumatic brain injuries, and intellectual/developmental disabilities.

Responsibilities

• Provide legal and compliance oversight related to Federal and State laws, rules, and regulations, with emphasis on Medicaid managed care for behavioral health and intellectual/developmental disability populations.
• Manage appeals of agency actions by providers and members.
• Oversee contracting with state and local agencies, providers, vendors, and other entities.
• Direct all litigation and legal disputes involving the organization.
• Review and revise policies, procedures, forms, templates, and correspondence; monitor organizational compliance.
• Respond to staff inquiries on legal issues and provide counsel regarding disputes with enrollees, providers, vendors, or other stakeholders.
• Handle public policy, governmental, and legislative affairs.
• Conduct internal compliance monitoring.
• Manage vendor integration and commercial contract management.
• Supervise the appeals unit responsible for in-house reviews of appeals related to agency decisions, authorization requests, provider actions, and claims denials.
• Prepare employees for depositions and court appearances; respond to subpoenas; coordinate with judicial and legal authorities.
• Oversee requests for documents under the North Carolina Public Records law.

Requirements

• Extensive knowledge of Federal and State laws and regulations related to Medicaid managed care, behavioral health, and intellectual/developmental disabilities.
• Experience in legal oversight of contracting, litigation, compliance monitoring, and appeals processes.
• Ability to provide legal advice and counsel to staff and stakeholders.
• Strong skills in managing public policy and legislative affairs.
• Proven leadership in supervising legal teams and managing complex legal matters.

Compensation & Benefits

• Salary range: $252,000 to $352,807 annually.
• Remote work within North Carolina.
• Competitive benefits package.
• Opportunities for professional growth.

Location

• Remote position within North Carolina.