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Zenith is a team of Workers’ Compensation Specialists committed to helping businesses succeed by protecting against the financial and human consequences of workplace injuries, providing for the needs of injured employees and making the workplace safer. To distinguish ourselves as the desired provider of Workers’ Compensation Insurance, values such as collaboration, work-life balance, and integrity are placed at the center of all our operations. In addition, Zenith supports career advancement through a dedication to ongoing learning and development. An individual coming to Zenith will not only receive competitive compensation and a comprehensive benefits package, but continuous opportunities to grow as a professional. The Vice President, Assistant General Counsel (AGC) will support Zenith's med-legal functions, including networks, medical management and bill review. As the med-legal subject matter expert, the AGC will, for example, provide risk analysis for business initiatives, obtain and maintain network and utilization review (UR) certifications, provide advice for network and UR defense, review bill review edits, explanation of reviews and other bill review materials. The AGC will work closely with Zenith's Chief Compliance Officer for all assigned areas. The AGC will also support legislative affair activities and often take the lead as subject matter expert to participate with industry on pending rules, regulations and laws. The AGC will interact regularly with regulators and other outside parties as necessary to represent Zenith. The AGC reports directly to Zenith's General Counsel.
What you will do
Provide legal and compliance support and work collaboratively with all parts of the business operation on med-legal issues; Continue to build expertise in state and federal insurance laws and regulations related to networks, utilization review, medical director and nurse licensing requirements, bill review requirements and other topics affecting networks, medical management and bill review; Monitor and help implement relevant changes to insurance laws, regulation and guidance within assigned areas; Regulatory research, filing preparation, compliance review audits, and interaction with state insurance regulators; Develop and maintain collaborative relationships with management and internal business clients, agents, outside counsel and Company partners to gain a deep understanding of the Company’s business, challenges, risks and opportunities; Participate in providing general legal support to various business operations of the Company; Perform other duties as assigned.
Juris Doctorate Law school graduate and member in good standing of the State Bar of California or eligible for Registered In-House Counsel in California required
10+ Years Workers’ Compensation or healthcare laws and regulations preferred
Skills and Abilities
Experience with network management, utilization review, bill review and provider relations highly preferred;, Excellent written and verbal communication skills;, Strong quantitative, analytical, and creative problem-solving skills; comfortable operating in gray;, Willing to travel to branch offices as needed.
Internal Number: TEMPL01782
About Zenith Insurance Company
Zenith is the premier specialist in workers’ compensation nationally, and a leader in property and casualty insurance for the California agriculture industry. We combine depth of expertise with a forward-thinking approach to achieve the highest level of service and outcomes for our clients.
We believe insurance is a long-term investment in your employees and the success of your business. Great businesses become even better when they invest in the best. With every company we protect, we work to help you maximize your return on insurance.
What sets us apart is our people-first approach. By getting to know you and your unique operation, we’re able to guide you toward generating more value in the long run, so you can keep your business – and your employees – safe and productive.
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