Overview

 

Focus Area: Government Sponsored Programs

The Associate General Counsel (AGC)
will be a Director-level member of Blue Shield’s Law Department and will be a
leader in the company. The Law Department partners with the company’s business
leaders to embrace legal and ethical behavior in the achievement of the
company’s mission. This team is highly regarded within the company and
respected by management. It is comprised of top tier, analytical and
intelligent attorneys; paralegals; contract and regulatory specialists;
compliance specialists; and administrative support staff. The AGC will provide
advice and counsel on a broad range of health law issues, with a particular
focus on supporting the company’s Blue Shield of California Promise Health Plan
(Blue Shield Promise) subsidiary, which operates Medicare, Medi-Cal (Medicaid),
and Cal Medi-Connect lines of business. The AGC must comfortably adapt to
change, skillfully and quickly master new responsibilities, demonstrate strong
business acumen, and possess a strong drive for excellence.

 

RESPONSIBILITIES:

  • Provide thoughtful, creative and timely
    legal advice to various business units on day-to-day regulatory and operational
    matters.
  • Provide well informed advice and legal
    support related to a variety of matters including litigation, arbitrations,
    dispute resolution, responses to regulatory actions, and overpayment recovery
    efforts.
  • Work collaboratively with a broad range
    of stakeholders, developing and maintaining strong relationships between the
    Law Department, as well as Care1st’s and BSC’s business units.
  • Communicate with regulatory agencies to
    submit and seek approval of filings and responses to audits and examinations.
  • Provide guidance and training to legal
    support staff in support of the Law Department’s goals.

 

Qualifications

 

Professional Qualifications:

  • Seven
    or more years of legal experience.
  • Expertise
    providing managed care legal advice to managed care organizations and/ or
    providers, with a focus on the Medicare and Medi-Cal programs preferred.
  • Recent
    litigation experience, including recent court appearances, arbitrations, and
    mediation. Experience managing outside counsel preferred
  • Knowledge
    of the Knox-Keene Health Care Service Plan Act, Medicare Rules and Regulations,
    HIPAA, Stark laws, and False Claims Act.
  • Strong
    ability to provide risk assessment/ risk mitigation support.
  • Strong
    negotiation skills
  • Combination
    of law firm and in-house experience preferred
  • JD
    from a respected law school and Bar admission (CA preferred)

 

Personal Qualifications:

  • Excellent
    written, verbal and interpersonal communication skills, with a keen ability to
    communicate effectively throughout all levels of the organization, as well as
    across organizations.
  • Personal
    presence, credibility, and the professional demeanor necessary to interact with
    company management, regulatory bodies, and business units with persuasiveness
    and confidence
  • Collaborative
    team player with an ability to play multiple roles
  • Adaptable;
    flexible; comfortable with uncertainly and ambiguity
  • Ready,
    willing and able to assist with new needs; responsive
  • Ability
    to influence a diverse set of stakeholders; positive disposition
  • Self-motivated
    and enthusiastic
  • Efficient,
    with a propensity for action and a strong sense of ownership
  • Personal
    integrity, excellent judgment and ability to prioritize and make difficult
    decisions quickly
  • Hands-on,
    hard-working, “roll up your sleeves” style
  • Business
    orientation and acumen
  • Practical
    and solution-oriented

 

Physical Requirements 

Office Environment – roles involving part to full time schedule in Office Environment. Based in our physical offices and work from home office/deskwork – Activity level: Sedentary, frequency most of work day.
Please click here for further physical requirement detail.

  

Job

: Legal Counsel

Primary Location

: United States of America-California-San Francisco

Organization

: Law

Schedule

: Full-time

Job Posting

: Jan 3, 2019, 2:14:12 AM 

External hires must pass a background check/drug screen. Qualified applicants with arrest records and/or conviction records will be considered for employment in a manner consistent with Federal, State and local laws, including but not limited to the San Francisco Fair Chance Ordinance. All qualified applicants will receive consideration for employment without regards to race, color, religion, sex, national origin, sexual orientation, gender identity, protected veteran status or disability status and any other classification protected by Federal, State and local laws.

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