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vice president associate general counsel resume example with 15+ years of experience

Jessica Claire
  • , , 609 Johnson Ave., 49204, Tulsa, OK 100 Montgomery St. 10th Floor
  • H: (555) 432-1000
  • C:
  • resumesample@example.com
  • Date of Birth:
  • India:
  • :
  • single:
  • :
Professional Summary

Dedicated legal professional offering expertise in Health law. Hardworking and dedicated to client advocacy. Regional General Counsel with seventeen (17) years of experience in advising company leaders and decision-makers on important legal matters. Accomplished in project management, leadership and team collaboration. Innovative in creatively solving problems while adhering to company values, policies and procedures. Proven success in building trusting rapport with clients and offering sound legal advice in clear and universal terms. Hardworking and dedicated to client advocacy.

Skills
  • Corporate law
  • Corporate and business legal issues
  • Legal compliance
  • Evaluating contracts
  • Health Care
  • Settlement Negotiation
  • Drafting Client Agreements
  • Privacy
  • Regulatory
Work History
Vice President & Associate General Counsel, 08/2015 - Current
Constellation Brands Gonzales, CA,
  • Executive Leadership Team for Tri-State/Mid-Atlantic Region advising on legal implications of proposed strategies, actions, and policies related to all lines of business and clients
  • Regional General Counsel for all legal matters related to Tri-State/Mid-Atlantic Region for Beacon including Connecticut, District of Columbia, Delaware, Maryland, New Jersey, New York, and Pennsylvania
  • Provide confidential legal opinions, interpretations, recommendations, and other legal services to corporate and regional C-Suite executives including but not limited to Chief Executive Officer, Chief Operating Officer, Chief Financial Officer, Chief Information Officer, Chief Information Officer, Chief Legal Officer, Chief Growth Officer, and Regional Market Presidents (collectively known as executive leadership of the organization) and, at their request, to other Vice Presidents, senior managers and persons responsible for managing the organization
  • Represent organization in formation, negotiation, documentation, and implementation of major transactions and lines of business with significant legal or compliance dimension which includes interacting with wide variety of outside parties such as public and private funding and regulatory agencies, potential business partners, contractors and vendors, outside counsel, and opposing counsel
  • Coordinates with Beacon government relations and policy team to ensure timely integration of legislative and regulatory developments into company practice
  • Manages Regulatory Analyst to track newly enacted legislation and/or promulgated regulations and to coordinate communications with impacted Regions and Compliance department
  • Manage outside counsel to defend and prosecute lawsuits and arbitrations
  • Lead counsel for issues related to Provider Service Agreements including but not limited to drafting of contract templates and amendments, and managing complex contract negotiations.
FIDA Project Director, 01/2014 - 07/2015
Target Aurora, CO,
  • Direct administrative and staff management of fully integrated duals advantage (FIDA) demonstration as well as perform overall project management for program
  • Oversee and manage implementation of FIDA program including but not limited to policy development, stakeholder outreach, education and engagement; enrollment broker activities; plan readiness review; participant ombudsman office initiation; provider and plan training; development and oversight of quality and network adequacy requirements; actuarial analysis and rate setting; state level information technology systems modifications and developments; and development of integrated appeals and grievances process
  • Responsible for ensuring that demonstration is operating in compliance with memorandum of understanding between Centers for Medicare and Medicaid Services (CMS) and New York State Department of Health (NYSDOH) and three-way contract between plans, CMS and NYSDOH
  • Regularly present demonstration progress to CMS and other internal/external stakeholders including but not limited to monthly updates at Medicaid Managed Care Policy and Planning Meeting, Provider association webinars and trainings, Administrative Law Judge training, New York State Bar Association Continuing Legal Education training, weekly health plan calls and television appearance on CMS and You.
Director, 12/2011 - 01/2014
Pacific Medical Centers Medford, OR,
  • Managed operations for all national network strategies and solutions related to Northeast (including Metro NYC) and other selected key markets across network including but not limited to, planning, directing, organizing and evaluating implementation of strategic plans to ensure consistency across regional operations and effective collaboration with national and regional developments
  • Oversaw network contracting function in all Northeast region service centers, including provider network management and development, and maintenance of network composition to ensure access and availability
  • Successfully led key provider network implementations of commercial, health plan and government clients including dual eligible networks
  • Led inter-company team of executive and senior management staff from both ValueOptions and MBHP, a ValueOptions subsidiary in Boston, Massachusetts in development of effective network strategy to support proposal for dual eligible demonstration partnership with Blue Cross Blue Shield of Massachusetts (BCBSMA) and ValueOptions Inc
  • Oversaw and managed key consultant engagement for implementation activities
  • Strategized with clinical staff in development of member facing protocols related to prior authorizations, health risk assessments, member engagement and risk stratification for various implementations
  • Collaborated with all business areas to finalize successful contract outcomes including Legal and Finance departments.
Associate Counsel, 11/2006 - 12/2011
MVP Health Care City, STATE,
  • Lead counsel for all matters related to commercial products and policy forms for 3 billion dollar revenue organization covering 650,000 lives and coordinating and working effectively with personnel at every level of business to ensure that strategic and operational goals were met through product development, drafting, filing and regulatory approval of MVP product portfolio
  • Lead Regulatory Counsel in New York, New Hampshire and Vermont including on issues related to Federal Health Care Reform, state reform, audits, member and provider appeals and market conduct evaluations
  • Monitored laws, regulations and provided guidance and communicated changes as appropriate including evaluation of business impact and options related to Federal Health Care Reform and other applicable federal and state laws
  • Worked with outside counsel successfully achieved change to federal health care reform guidance which conformed to existing MVP Product development strategies
  • Provider contracting for MVP network in New York, Vermont and New Hampshire, including direct provider contracting as well as through physician hospital organizations, independent practice associations and provider organizations
  • Efforts included negotiating with opposing counsel as well as advising business personnel with respect to issues such as contract interpretation, credentialing, regulatory requirements, and strategy
  • Provided subject matter expertise on legal aspects of health plan operations
  • Identify key areas of risk and educate staff as to risk prevention
  • Other practice areas included: Advertising, Pharmacy, Behavioral Health, Credentialing, Quality, Provider Relations, Wellness, National Networks, Sales, Actuarial and Member Appeals
  • Provided legal support for various departments and cross-disciplinary teams, such as provider network relations, claims processing, customer service, marketing, product development, corporate shared services, information technology, procurement, and regulatory affairs
  • Collaborated with Government Affairs department to assist in shaping favorable legislation for organization
  • Worked collaboratively with executive and leadership teams as well as other attorneys including seeking and exchanging knowledge and engaging in joint problem solving, risk assessment and strategic planning
  • Oversaw and mentored junior attorneys and paralegal staff and coordinated, managed and collaborated with outside counsel attorneys in New York, Vermont and New Hampshire
  • MVP PAC Advisory Board Member
  • Exchange Leadership Team Member: Founding team member tasked with developing strategic recommendations related to introduction of Exchanges into market under PPACA
  • Responsible for educating company stakeholders on Exchanges including regulatory updates, changes and guidelines
  • Assessed potential impact of Exchanges on MVP’s functional areas as well as provide communication and analysis to Senior Executives
  • Participated in selection and management of consulting engagement in preparation for Exchanges.
Education
Juris Doctor: International Law, Expected in 05/2004
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ALBANY LAW SCHOOL of UNION UNIVERSITY - Albany, New York
GPA:
Status -

Moot Court: Donna Jo Morse Negotiation Competition Alternative Dispute Resolution Training Phi Alpha Delta Law Fraternity

Bachelor of Arts: European History, French, Expected in 05/1999
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DePAUW UNIVERSITY, College of Liberal Art - Greencastle, Indiana
GPA:
Status -

1995 - 1999 Kappa Kappa Gamma Fraternity, Executive Officer

: , Expected in
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Harvard University - Cambridge, MA
GPA:
Status -

Intensive Italian Polonsky Foundation Scholarship, Academic Excellence Award

Languages
English :
Native or Bilingual:
Negotiated :
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French :
Limited Working:
Negotiated :
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Spanish :
Limited Working:
Negotiated :
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Italian :
Limited Working:
Negotiated :
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Portuguese :
Elementary:
Negotiated :
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Resume Overview

School Attended

  • ALBANY LAW SCHOOL of UNION UNIVERSITY
  • DePAUW UNIVERSITY, College of Liberal Art
  • Harvard University

Job Titles Held:

  • Vice President & Associate General Counsel
  • FIDA Project Director
  • Director
  • Associate Counsel

Degrees

  • Juris Doctor
  • Bachelor of Arts

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