Chief Legal Officer & General Counsel
CurrentFounded legal department. Full legal support to all business units of one-third billion dollar, 425+FTE, URAC-accredited managed care organization (MCO), which oversees publicly-funded behavioral healthcare (mental health, substance abuse and intellectual/developmental disabilities) service system for just under one million residents of eight North Carolina counties from SC to Virginia borders. Partners was formed July 1, 2012 through the merger of three long-established Local Management Entities (LMEs) and performs contracted functions under the Medicaid Section 1915(b)/(c) Waiver for North Carolina as approved by the U.S. DHHS Centers for Medicare & Medicaid Services (CMS), as well as state-, county- and grant-funded programs. Member of Executive Leadership Team. Direct supervision over Legal, Program Integrity, Waiver Management, Grievances, and Policies & Procedures. Areas of responsibility and/or assistance include litigation and litigation management (administrative, state and federal); consumer and provider disputes, appeals, grievances, procedures and operations; provider and vendor contracting; compliance (including HIPAA, privacy and procedures/policies drafting and implementation); employment; board/governance; state and federal audits/investigations; regulatory, community and stakeholder relations; general operations guidance and training, including for utilization management, care coordination, and provider credentialing issues; and various legal budgetary and administrative matters.
