Under the direction of the Chief Counsel of the Office of the Director-Legal Unit (OD-Legal), represent the Director of Industrial Relations and the Administrative Director of the Division of Workers’ Compensation, and the Department in combating all forms of workers' compensation fraud, and protecting the welfare of injured workers. The incumbent performs a critical leadership role in planning, organizing, directing, and evaluating the administrative, investigative, policy, and litigation activities aimed at eliminating fraud in the workers’ compensation system. The position requires expertise in prosecution procedure, experience specializing in workers’ compensation law, and detailed understanding of California’s complex workers’ compensation system. The duties of this position include responsibility for planning, organizing, directing, coordinating, and reviewing the work of a professional legal staff; providing legal representation to enforce the anti-fraud statutes; acting as legal advisor to top management; formulating legal policy; and participating as a member of top management in the development and implementation of department policy. An Active State of California Bar License is required.
Provide executive oversight and policy development, fraud detection, fraud control, and communications. Develop and continuously refine administrative legal strategies to effectively deter existing and emerging fraudulent activity in the workers’ compensation system. Key components of the work include: Strategy: (a) Identifying and articulating anti-fraud objectives in support of overall DIR’s policy and mission, (b) Assuring the anti-fraud activities are aligned with agencies and departments such as Labor and Workforce Development Agency (LWDA), California Development of Insurance (CDI), etc., to maximize overall value to the state.
Execution: (a) Creating a systematic, repeatable and documented process to carry out anti-fraud activities; (b) Organizing the anti-fraud work to most effectively and efficiently deliver the DIR anti-fraud strategy; and (c) Representing DIR at provider suspension appeal hearings, special lien proceedings for convicted suspended providers, writ proceedings involving appeals of providers suspensions, litigation in state and federal courts, and in all administrative and court appeals of lien consolidations and dismissals.
Supervise attorneys, investigators, and staff on the work of suspected worker’s compensation fraud, including, but not limited to activities by medical providers, suppliers, attorneys and employers. Provide ongoing oversight and direction of staff to carry out work in accordance with the anti-fraud plan, California Labor Code and other applicable state and federal laws. Ensure that confidentiality of investigation is maintained by all staff to protect DIR from civil liability.
Act as lead responsible for interaction with internal and external entities including, but not limited to: Labor and Workforce Development Agency, DIR Division of Workers’ Compensation; CDI; Department Of Justice; State Compensations Insurance Fund; Federal and state court prosecutions; professional licensing agencies, California Workers' Compensation Insurance Rating Bureau of California, Medicare, and Medi-Cal; through plans, timetables and outcome reports.
Ensure adequate staffing of qualified professionals through recruitment, selection, and training. Other duties as required.
Under the direction of the Chief Counsel of the Office of the Director-Legal Unit (OD-Legal), represent the Director of Industrial Relations and the Administrative Director of the Division of Workers’ Compensation, and the Department in…
Applicants must have active membership in the State Bar of California.
In addition to the State Examination/Employment Application (STD 678), all interested applicants are required to submit a Statement of Qualifications (SOQ) responding to the questions below. Within the response, include specific information as to how your professional experience, knowledge, skills, and abilities meet the qualifications and desirable qualifications of this position.
Please limit your SOQ to a maximum of 10 pages, double-spaced, 12-point Arial font or Times New Roman, and 1-inch margins.
Applicants who do not follow these requirements or who do not provide responses to the specific 8 questions below will be disqualified from this examination. Cover letters and resumes do not take the place of the SOQ.
Please respond to the following questions in your SOQ and note that legal experience is defined as experience acquired after admission to any State Bar.
1. Describe your experience managing or leading an operation in a private or public environment that demonstrates an ability to manage a team(s) for a program or business objective.
2. Describe your experience supervising employees in a legal setting including the number of staff (i.e., attorneys and legal support staff). Please include the number of years.
3. Describe a variety of metrics that can be used to measure and evaluate the efficacy of program procedures or a business process, as well as to measure the performance of staff in meeting program/business objectives.
4. Describe your knowledge and experience of the laws, procedures, and data management systems of the California Workers’ Compensation System. Please include the number of years.
5. Describe any experience you have had developing or implementing legislative or regulatory initiatives.
6. Describe your experience litigating in various forums including any trial work (civil, administrative, and/or criminal). Please include the number of years.
7. Describe the nature of the cases you have handled (including anti-fraud, unfair business practices, cases designated as complex, class actions, consumer litigation, etc.).
8. Describe your experience hiring and training employees and personnel.
Candidates will also be evaluated on how clearly and concisely their qualifications were presented throughout the SOQ.
Applications received without a Statement of Qualification responding to the 8 questions specified above will be rejected.