Attorney Advisor

Duties

DCHBX Social Justice Values Statement

We believe in social justice and the power of diversity, equity, and inclusion, and are committed to fighting longstanding discrimination, racial injustice, and systemic racism to contribute to a more just and equitable future for our workforce, our customers, and our partners.

INTRODUCTION

This position is in the District of Columbia Health Benefit Exchange Authority (HBX) Legal Services Division. The mission of the Health Benefit Exchange Authority is to implement a health care exchange program in the District of Columbia in accordance with the Patient Protection and Affordable Care Act (PPACA) of 2010 and the District of Columbia Health Benefit Exchange Authority Establishment Act of 2011, thereby ensuring access to quality and affordable health care to all District of Columbia residents.

The Attorney Advisor, as part of the Legal Services Division of the HBX, provides legal consultation to the HBX Board of Directors, senior management team and staff covering a wide range of practice areas as required by HBX operations. The incumbent is responsible for the agency's insurance product compliance and rate review process functions required by the federal Patient Protection and Affordable Care Act (ACA), the goal of which is to ensure that insurers and other entities, making health insurance products available in the District comply with federal standards meant to ensure consumer information is protected, and legal standards governing HIPPA protected information sharing are followed.

MAJOR DUTIES

Serves as a key senior advisor to the agency General Council, Deputy General Counsel, and the Executive Director in policy decision-making. In addition to serving as confidant and troubleshooter, works closely with the HBX General Counsel, Deputy General Counsel, the Executive Director, and staff in the planning, coordination and management of the legal consultation provided to the agency.

Advises agency staff overseeing insurance products offered through DC Health Link; establishes standards for risk adjustment for reinsurance programs; and monitors the program in compliance with laws, rules, and regulations governing the office. Reviews and makes recommendations on revisions of rules, regulations, or laws affecting the program.

Develops and institutes program integrity and compliance guidelines, new and improved policies, procedures, and processes to effect efficient program operations.

Performs research and preparation of responses for the agency General Counsel, Deputy General Counsel, Executive Director, and other members of the agency's senior management team to selected and sensitive, and often confidential inquiries and correspondence from members of Congress, the Mayor, members of the Council of the District of Columbia, officials of the District and Federal governments, the media, those of surrounding jurisdictions, members of the private sector, and the general public.

Prepares testimony for Executive Director, Executive Board members, or senior management for presentation at hearings before the Council of the District of Columbia, congressional committees, and other public appearances.

Prepares legal documents on complex and substantive matters of an urgent nature, providing summary analyses of issues and recommendations for consideration of the agency General Counsel, Deputy General Counsel, Executive Director, and/or Board of Directors.

Conducts extensive and detailed research of legal documents dealing with proposed laws and amendments to existing laws to ensure conformance with legal requirements. Prepares analysis of policy options and recommendations.

Conducts regular audits of agency programs to determine their integrity and effectiveness, identifying deficiencies or gaps in information privacy and recommends improvements.

Drafts contracts on behalf of DCHBX for use with QHP issuers; drafts and reviews MOUs with other District agencies, and drafts and reviews other written agreements for services.

Devises and implements feedback systems, performance measures and benchmarks to assure adequate performance, and successful goal achievement. Identifies barriers to quality legal services; to design effective strategies; to resolve issues; and to implement corrective actions.

Performs other related duties as assigned.

KNOWLEDGE REQUIRED BY THE POSITION

Mastery knowledge of legal research and analysis. Mastery knowledge of law and legal precedents, practices, and procedures.

Mastery knowledge of legal terminology. Demonstrated ability to provide interpretation of statutes, regulations, and policies, and to apply such interpretation to specific legal and policy matters. Mastery knowledge of legal advocacy tactics and strategies.

Mastery knowledge of the mission, functions, organization, policies, and system requirements of the District and the Federal governments, as well as mission and work processes of the Health Benefit Exchange Authority.

In-depth knowledge and experience with the PPACA, HIPAA, ERISA, and PHSA. In-depth knowledge of and experience working on federal statutory and regulatory provisions of PPACA, including American Health Benefit Exchange Structures, the essential health benefits, insurance market reform rules, and rules governing employer-sponsored insurance.

Mastery knowledge of qualitative and quantitative analytic methods and techniques to analyze data; and to identify and isolate controlling legal issues from complex factual situations. Highly skilled in negotiating and building coalitions of diverse stakeholders.

Highly developed skills in the analysis and resolution of difficult legal issues in an orderly, systematic, and effective manner. Highly skilled in interpreting and applying legal knowledge in various situations. Highly skilled in interpreting and applying applicable laws, regulations, and practices, including agency policies and relevant judicial decisions.

Superior oral and written communication skills to advise and consult with high-ranking official; to prepare and present reports; and to assure effective and efficient communication on legal matters. Skill in establishing and maintaining effective working relationships with individuals and groups interested in or affected by the function of the HBX.

SUPERVISORY CONTROLS

Incumbent performs under the administrative supervision of the Deputy General Counsel, who provides broadly defined objectives and functions. Incumbent proceeds with considerable latitude in the performance of responsibilities.

Confers with supervisor regarding the impact of proposed decisions as they relate to program goals and jurisdictional practices. Keeps supervisor informed on all major and sensitive issues. Work is reviewed for overall effectiveness. Results of work are considered authoritative and are normally accepted.

GUIDELINES

Guidelines include Mayoral directives; policies and procedures approved established by the HBX Board of Directors; reported legal decisions and other reference works; administrative, legislative and judicial rules and regulations; Acts of Congress and the Council of the District of Columbia and other laws applicable to the District of Columbia; reciprocal agreements and laws; regulations of the District of Columbia and Federal agencies; current decisions of local trial and appellate courts and the U.S. Supreme Court, as well as decisions of other jurisdictions; and, pending litigation and active legal matters.

The incumbent demonstrates ingenuity, and sound judgment in interpreting the intent of the guides that do exist and in developing new or innovative approaches or adapting applications to specific problems or areas of the work. The incumbent is recognized as a professional authority in the development and interpretation of guidelines.

COMPLEXITY

Work involves extremely complex and difficult legal questions and issues, in the absence of established legal decisions. The work requires the incumbent to use sound judgment and a high degree of original and creative legal endeavor in the resolution of assigned matters to successfully represent the interest of the District of Columbia Government. Work requires continuous efforts to establish, develop, and revise legislative requirements and enforcement actions to deal with unforeseen problems and obstacles.

SCOPE AND EFFECT

The purpose of this position is to serve as legal advisor, confidant, and troubleshooter, providing legal consultation to HBX Board of Directors, Executive Director, General Counsel,

Deputy General Counsel, senior management team and staff, covering a wide range of practice areas, as required by the HBX operations. The work contributes to the overall effective and efficient accomplishment of the mission of HBX.

PERSONAL CONTACTS

Personal contacts are with workers, officials of District and Federal government agencies, and various other persons with expertise in areas related to assigned matters. Incumbent determines the nature and extent of contacts required, which vary from case to case.

PURPOSE OF CONTACTS

Contacts generally involve obtaining or exchanging factual information related to assigned matters; advising concerned parties of tentative decisions; securing expert advice to support evidence in decisions rendered; and advising interested agency personnel concerning status of pending matters.

PHYSICAL DEMANDS

Work is sedentary; however, some walking, standing, and bending are encountered.

WORK ENVIRONMENT

The work is performed in an office environment.

OTHER SIGNIFICANT FACTS

This position requires a Juris Doctor (J.D.) from an accredited law school by the American Bar Association (ABA) at the time of appointment, plus a minimum of four (4) years of experience in the legal field. Incumbent mut be an active member in good standing of the bar of the District of Columbia, or eligible for waiver into the bar. (If eligible for waiver, incumbent must successfully obtain admission to the D.C.

Bar within 360 days of commencing employment). Demonstrated experience working in a health-related industry. Federal, State or City level insurance regulatory is highly desirable.

The incumbent of this position will be subject to enhanced suitability screening pursuant to Chapter 4 of DC Personnel Regulations, Suitability - Security Sensitive.