Boston, Massachusetts, USA
10 days ago
Health Attorney

About the Organization:

The Division of Insurance ("DOI"), an Agency within the Office of Consumer Affairs and Business Regulation, administers the Commonwealth’s insurance consumer protection laws through its regulation of the insurance industry. The primary mission of the Division is to monitor the solvency of its licensees in order to promote a healthy, responsive and willing marketplace for consumers who purchase insurance products. The Division also investigates and responds to consumer inquiries and complaints, enforces state insurance laws and regulations, and provides the public with accurate and unbiased insurance information. An important aspect of the Division’s work is ensuring that the individuals and business entities conducting the business of insurance in Massachusetts do so in a legal and timely manner.

The Division of Insurance is committed to creating and sustaining a work culture that is welcoming, inclusive, and mutually respectful to all its employees regardless of race, color, age, creed, religion, national origin, ethnicity, sex, gender identity or expression, sexual orientation, genetic information, veteran or disability status. We strive to reflect diversity in all facets and levels of our agency. The Division of Insurance values inclusiveness and diversity within their employee and management teams. Within our community we strive to create and maintain working and learning environments that are inclusive, equitable, and welcoming.

The Division of Insurance is committed to ensuring a diverse and inclusive workplace where all employees feel respected, valued, and empowered to maximize their skills and talents to serve our citizens.

About the Role:

The basic purpose of this position is to act as a Health Attorney within the Division of Insurance. This work shall include, but not be limited to, the following areas: the Commonwealth’s Merged Market Health Insurance market (M.G.L. c. 176J); Health Insurance Consumer Protection (M.G.L. c. 176O); Mental Health Parity requirements and enforcement (M.G.L. c. 8, §§ 8K, 8L and 8M); and regulation of Pharmacy Benefit Managers (M.G.L. c. 176Y as enacted by Chapter 342 of the Acts of 2024). The employee will represent the agency’s position and statutory obligations in all health-care-related matters including administrative hearings on rate filings and enforcement matters, ensuring that agency activities and health-care carriers and other regulated entities comply with the laws. Provide legal advice within the agency and handle legal inquiries from other agencies, regulated entities, interested parties and the public. Assist with the drafting of health-related legislation and regulations. Represent the agency at meetings, hearings and special sessions.

Duties and Responsibilities:

Advises agency staff on legal matters by interpreting laws, rules, regulations and judicial or quasi-judicial decisions and opinions related to agency operations, including enforcement matters; reviewing court decisions and newly enacted state and federal regulations to determine their applicability to agency activities; reviewing drafts of proposed agency regulations, guidelines and contracts for conformity with applicable laws and regulations; conducting legal research on matters related to agency functions; preparing opinions; reviewing draft decisions for clarity and for evidentiary and legal foundation; and training agency staff in such matters as the laws, rules, regulations, policies and procedures governing agency operations.Provides information to the public by answering inquiries related to agency functions, rules and regulations and by speaking before citizen groups and/or other interested parties regarding agency legal issues and procedures to ensure the accurate presentation of the agency's functions, positions on various issues and policies.Performs related duties such as writing correspondence and reports; scheduling hearings and conferences; updating reference materials such as laws, rules and regulations; and maintaining and updating periodic status and/or statistical reports on such matters as proposed legislation.Represents agency at administrative hearings, including rate and enforcement hearings, by interviewing witnesses, presenting evidence and oral arguments in support of the agency's position, filing motions and answers to complaints, and conferring with other counsel to promote the agency's position and statutory obligations.Obtains information needed to represent the agency in court or at administrative hearings, including rate and enforcement hearings, by conducting pre-hearing conferences to clarify issues or encourage settlement; interviewing witnesses; consulting other agency staff and legal representatives of the parties involved; reviewing case files, transcripts of previous hearings, administrative decisions and other records of case proceedings; conducting legal research; and reviewing memoranda submitted by litigant representatives for rebuttal to determine issues involved, legal precedents and whether further investigation is needed to provide additional documentation.Prepares cases for trials or administrative hearings, including rate and enforcement hearings, by evaluating complaints to determine if they warrant court action; deciding which cases to prosecute; determining legal strategy to be used in the prosecution, defense or settlement of cases through all levels of court jurisdiction; determining which documents or persons to subpoena; determining which witnesses will appear in court or at hearings in connection with civil or criminal cases; preparing legal briefs, complaints and memoranda of law; assembling and organizing supportive documentation; and instructing parties in the procedural format of hearings to ensure that all testimony, evidence and legal precedents supporting the agency's position are adequately presented.Drafts administrative, court and legal documents; prepares consent orders and regulations; and reviews legal documents to ensure that such documents are complete, accurate and in compliance with law to avoid challenge.Reviews such documents as correspondence of the legislative committee reports to record information for future reference.Recommends standard operating procedures to be adopted by the agency.Consults with other legal counsel and agency officials regarding the appeal of agency decisions; consults with the Attorney General's office concerning litigation brought by providers, recipients and/or their legal representatives challenging agency policies and regulations; and maintains liaison with the Attorney General's office on suits filed in federal and state courts.Confers with other agency staff in drafting proposed legislation for submission to the Legislature and analyze proposed legislation to determine its impact on agency activities.Drafts regulations and legislation for the implementation of agency programs.Prepares instructions to agency units for the implementation of court decisions.Establishes and maintains liaison with representatives of other government agencies, including the legislature, through consultation and negotiation to develop memoranda of agreement on joint programs and to exchange information on such matters as agency budget allocations and proposed legislation.Prepares memoranda supporting or opposing legislation affecting agency operations.Negotiates settlements between consumers and company representatives to resolve complaints and/or disputes.Negotiates with legal staff of other agencies to develop memoranda of agreement concerning joint programs.Assist General Counsel and Deputy General Counsel in all matters deemed necessary.

Preferred Qualification:

Specialized Legal Expertise in health law at both state and federal levels.Extensive knowledge in health regulatory issues.Ability to address complicated legal issues such as the new health insurance laws.Ability to read and interpret legal documents such as decisions, briefs, opinions and contracts.Ability to understand and apply the laws, rules and regulations governing agency operations and assigned unit activities.Ability to exercise sound judgment.Ability to exercise discretion in handling confidential information.Ability to prepare technical and general reports.Ability to explain the provisions of the laws, rules and regulations governing agency operations and assigned unit activities.Ability to explain the procedures, guidelines and policies governing agency operations and assigned unit activities.Ability to analyze and determine the applicability of legal data, to draw conclusions and make appropriate recommendations.Ability to work independently.Ability to gather information through questioning and observing individuals and by examining records and documents.Ability to establish rapport and maintain harmonious working relationships.Ability to deal tactfully with others.Ability to maintain a calm manner in stressful and/or emergency situations.Ability to assemble items of information in accordance with established procedures.Ability to maintain accurate records.Ability to give written and oral instructions in a precise, understandable manner.Ability to conduct interviews.Ability to write concisely and effectively, to express thoughts clearly and to develop ideas in logical sequence.Ability to make effective oral presentations.Ability to communicate effectively in oral expression.Knowledge of the legal procedures involved in conducting public and executive hearings.Ability to interpret and apply the laws, rules and regulations governing taxation and/or consumerism/consumer protection.Knowledge of the theory, principles and practices of administrative law.Knowledge of the principles and practices of supervision.Knowledge of the theory, principles and practices of law including constitutional law.Knowledge of the procedures followed in courtroom proceedings.Knowledge of the terminology, symbols and standard abbreviations in legal practice.Knowledge of the methods of technical and general report writingKnowledge of legal research methods and procedures.Knowledge of training methods and techniques.Knowledge of interviewing techniques.Ability to conduct training or instruction Ability to determine proper format and procedure for assembling items of information

Qualifications Acquired on the Job:

Knowledge of the state law governing administrative hearingsKnowledge of the reference and related sources available for legal research.Knowledge of the laws and rules governing the presentation and admissibility of evidenceKnowledge of the laws, rules, regulations, policies, procedures, specifications, standards and guidelines governing agency operations and assigned unit activities.Knowledge of the principles and practices of records management.Knowledge of the types and availability to public or private organizations and sources for providing legal services.Knowledge of the laws, rules, and regulations governing taxation and consumerism/consumer protectionKnowledge of the theory, principles and practices of administrative law.Knowledge of training methods and techniques.Knowledge of interviewing techniques.Ability to conduct training or instruction.Knowledge of the principles, practices and techniques of supervision.

About the Organization:

The Division of Insurance ("DOI"), an Agency within the Office of Consumer Affairs and Business Regulation, administers the Commonwealth’s insurance consumer protection laws through its regulation of the insurance industry. The primary mission of the Division is to monitor the solvency of its licensees in order to promote a healthy, responsive and willing marketplace for consumers who purchase insurance products. The Division also investigates and responds to consumer inquiries and complaints, enforces state insurance laws and regulations, and provides the public with accurate and unbiased insurance information. An important aspect of the Division’s work is ensuring that the individuals and business entities conducting the business of insurance in Massachusetts do so in a legal and timely manner.

The Division of Insurance is committed to creating and sustaining a work culture that is welcoming, inclusive, and mutually respectful to all its employees regardless of race, color, age, creed, religion, national origin, ethnicity, sex, gender identity or expression, sexual orientation, genetic information, veteran or disability status. We strive to reflect diversity in all facets and levels of our agency. The Division of Insurance values inclusiveness and diversity within their employee and management teams. Within our community we strive to create and maintain working and learning environments that are inclusive, equitable, and welcoming.

The Division of Insurance is committed to ensuring a diverse and inclusive workplace where all employees feel respected, valued, and empowered to maximize their skills and talents to serve our citizens.

About the Role:

The basic purpose of this position is to act as a Health Attorney within the Division of Insurance. This work shall include, but not be limited to, the following areas: the Commonwealth’s Merged Market Health Insurance market (M.G.L. c. 176J); Health Insurance Consumer Protection (M.G.L. c. 176O); Mental Health Parity requirements and enforcement (M.G.L. c. 8, §§ 8K, 8L and 8M); and regulation of Pharmacy Benefit Managers (M.G.L. c. 176Y as enacted by Chapter 342 of the Acts of 2024). The employee will represent the agency’s position and statutory obligations in all health-care-related matters including administrative hearings on rate filings and enforcement matters, ensuring that agency activities and health-care carriers and other regulated entities comply with the laws. Provide legal advice within the agency and handle legal inquiries from other agencies, regulated entities, interested parties and the public. Assist with the drafting of health-related legislation and regulations. Represent the agency at meetings, hearings and special sessions.

Duties and Responsibilities:

Advises agency staff on legal matters by interpreting laws, rules, regulations and judicial or quasi-judicial decisions and opinions related to agency operations, including enforcement matters; reviewing court decisions and newly enacted state and federal regulations to determine their applicability to agency activities; reviewing drafts of proposed agency regulations, guidelines and contracts for conformity with applicable laws and regulations; conducting legal research on matters related to agency functions; preparing opinions; reviewing draft decisions for clarity and for evidentiary and legal foundation; and training agency staff in such matters as the laws, rules, regulations, policies and procedures governing agency operations.Provides information to the public by answering inquiries related to agency functions, rules and regulations and by speaking before citizen groups and/or other interested parties regarding agency legal issues and procedures to ensure the accurate presentation of the agency's functions, positions on various issues and policies.Performs related duties such as writing correspondence and reports; scheduling hearings and conferences; updating reference materials such as laws, rules and regulations; and maintaining and updating periodic status and/or statistical reports on such matters as proposed legislation.Represents agency at administrative hearings, including rate and enforcement hearings, by interviewing witnesses, presenting evidence and oral arguments in support of the agency's position, filing motions and answers to complaints, and conferring with other counsel to promote the agency's position and statutory obligations.Obtains information needed to represent the agency in court or at administrative hearings, including rate and enforcement hearings, by conducting pre-hearing conferences to clarify issues or encourage settlement; interviewing witnesses; consulting other agency staff and legal representatives of the parties involved; reviewing case files, transcripts of previous hearings, administrative decisions and other records of case proceedings; conducting legal research; and reviewing memoranda submitted by litigant representatives for rebuttal to determine issues involved, legal precedents and whether further investigation is needed to provide additional documentation.Prepares cases for trials or administrative hearings, including rate and enforcement hearings, by evaluating complaints to determine if they warrant court action; deciding which cases to prosecute; determining legal strategy to be used in the prosecution, defense or settlement of cases through all levels of court jurisdiction; determining which documents or persons to subpoena; determining which witnesses will appear in court or at hearings in connection with civil or criminal cases; preparing legal briefs, complaints and memoranda of law; assembling and organizing supportive documentation; and instructing parties in the procedural format of hearings to ensure that all testimony, evidence and legal precedents supporting the agency's position are adequately presented.Drafts administrative, court and legal documents; prepares consent orders and regulations; and reviews legal documents to ensure that such documents are complete, accurate and in compliance with law to avoid challenge.Reviews such documents as correspondence of the legislative committee reports to record information for future reference.Recommends standard operating procedures to be adopted by the agency.Consults with other legal counsel and agency officials regarding the appeal of agency decisions; consults with the Attorney General's office concerning litigation brought by providers, recipients and/or their legal representatives challenging agency policies and regulations; and maintains liaison with the Attorney General's office on suits filed in federal and state courts.Confers with other agency staff in drafting proposed legislation for submission to the Legislature and analyze proposed legislation to determine its impact on agency activities.Drafts regulations and legislation for the implementation of agency programs.Prepares instructions to agency units for the implementation of court decisions.Establishes and maintains liaison with representatives of other government agencies, including the legislature, through consultation and negotiation to develop memoranda of agreement on joint programs and to exchange information on such matters as agency budget allocations and proposed legislation.Prepares memoranda supporting or opposing legislation affecting agency operations.Negotiates settlements between consumers and company representatives to resolve complaints and/or disputes.Negotiates with legal staff of other agencies to develop memoranda of agreement concerning joint programs.Assist General Counsel and Deputy General Counsel in all matters deemed necessary.

Preferred Qualification:

Specialized Legal Expertise in health law at both state and federal levels.Extensive knowledge in health regulatory issues.Ability to address complicated legal issues such as the new health insurance laws.Ability to read and interpret legal documents such as decisions, briefs, opinions and contracts.Ability to understand and apply the laws, rules and regulations governing agency operations and assigned unit activities.Ability to exercise sound judgment.Ability to exercise discretion in handling confidential information.Ability to prepare technical and general reports.Ability to explain the provisions of the laws, rules and regulations governing agency operations and assigned unit activities.Ability to explain the procedures, guidelines and policies governing agency operations and assigned unit activities.Ability to analyze and determine the applicability of legal data, to draw conclusions and make appropriate recommendations.Ability to work independently.Ability to gather information through questioning and observing individuals and by examining records and documents.Ability to establish rapport and maintain harmonious working relationships.Ability to deal tactfully with others.Ability to maintain a calm manner in stressful and/or emergency situations.Ability to assemble items of information in accordance with established procedures.Ability to maintain accurate records.Ability to give written and oral instructions in a precise, understandable manner.Ability to conduct interviews.Ability to write concisely and effectively, to express thoughts clearly and to develop ideas in logical sequence.Ability to make effective oral presentations.Ability to communicate effectively in oral expression.Knowledge of the legal procedures involved in conducting public and executive hearings.Ability to interpret and apply the laws, rules and regulations governing taxation and/or consumerism/consumer protection.Knowledge of the theory, principles and practices of administrative law.Knowledge of the principles and practices of supervision.Knowledge of the theory, principles and practices of law including constitutional law.Knowledge of the procedures followed in courtroom proceedings.Knowledge of the terminology, symbols and standard abbreviations in legal practice.Knowledge of the methods of technical and general report writingKnowledge of legal research methods and procedures.Knowledge of training methods and techniques.Knowledge of interviewing techniques.Ability to conduct training or instruction Ability to determine proper format and procedure for assembling items of information

Qualifications Acquired on the Job:

Knowledge of the state law governing administrative hearingsKnowledge of the reference and related sources available for legal research.Knowledge of the laws and rules governing the presentation and admissibility of evidenceKnowledge of the laws, rules, regulations, policies, procedures, specifications, standards and guidelines governing agency operations and assigned unit activities.Knowledge of the principles and practices of records management.Knowledge of the types and availability to public or private organizations and sources for providing legal services.Knowledge of the laws, rules, and regulations governing taxation and consumerism/consumer protectionKnowledge of the theory, principles and practices of administrative law.Knowledge of training methods and techniques.Knowledge of interviewing techniques.Ability to conduct training or instruction.Knowledge of the principles, practices and techniques of supervision.

First consideration will be given to those applicants that apply within the first 14 days.

MINIMUM ENTRANCE REQUIREMENTS: Applicants must have a Juris Doctor (JD) degree, admission to the Massachusetts Bar and (A) at least three years of full-time, or equivalent part-time, professional experience in the practice of law.

Incumbents may be required to have a current and valid Motor Vehicle Drivers License at a Class level specific to assignment.

Comprehensive Benefits

When you embark on a career with the Commonwealth, you are offered an outstanding suite of employee benefits that add to the overall value of your compensation package. We take pride in providing a work experience that supports you, your loved ones, and your future.

Want the specifics?Explore our Employee Benefits and Rewards

An Equal Opportunity / Affirmative Action Employer.Females, minorities, veterans, and persons with disabilities are strongly encouraged to apply.

The Commonwealth is an Equal Opportunity Employer and does not discriminate on the basis of race, religion, color, sex, gender identity or expression, sexual orientation, age, disability, national origin, veteran status, or any other basis covered by appropriate law. Research suggests that qualified women, Black, Indigenous, and Persons of Color (BIPOC)may self-select out of opportunities if they don't meet 100% of the job requirements. We encourage individuals who believe they have the skills necessary to thrive to apply for this role.

First consideration will be given to those applicants that apply within the first 14 days.

MINIMUM ENTRANCE REQUIREMENTS: Applicants must have a Juris Doctor (JD) degree, admission to the Massachusetts Bar and (A) at least three years of full-time, or equivalent part-time, professional experience in the practice of law.

Incumbents may be required to have a current and valid Motor Vehicle Drivers License at a Class level specific to assignment.

Comprehensive Benefits

When you embark on a career with the Commonwealth, you are offered an outstanding suite of employee benefits that add to the overall value of your compensation package. We take pride in providing a work experience that supports you, your loved ones, and your future.

Want the specifics?Explore our Employee Benefits and Rewards

An Equal Opportunity / Affirmative Action Employer.Females, minorities, veterans, and persons with disabilities are strongly encouraged to apply.

The Commonwealth is an Equal Opportunity Employer and does not discriminate on the basis of race, religion, color, sex, gender identity or expression, sexual orientation, age, disability, national origin, veteran status, or any other basis covered by appropriate law. Research suggests that qualified women, Black, Indigenous, and Persons of Color (BIPOC)may self-select out of opportunities if they don't meet 100% of the job requirements. We encourage individuals who believe they have the skills necessary to thrive to apply for this role.

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