Senior Director, Legal Counsel
Blue Shield of CA
The Associate General Counsel (AGC) will be a Director-level
member of Blue Shield of California’s (BSC) 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 government sponsored programs , which includes
Medicare, Cal Medi-Connect and Medi-Cal (Medicaid) lines of
business. The AGC must comfortably adapt to change, skillfully
and quickly master new responsibilities, have demonstrated a
strong business acumen, and possess a strong drive for
- Provide thoughtful, creative and timely legal advice to various BSC and Promise Health Plan, BSC’s subsidiary, business units related to government programs with a focus on Medicare and Cal Medi-Connect.
- Provide well informed advice and legal support related to a variety of matters including regulatory inquiries, vendor contracting, initiative programs and pilots, audits and surveys, clinic obligations and services, enrollee and member issues and provider concerns.
- Work collaboratively with a broad range of stakeholders, developing and maintaining strong relationships between the Law Department, as well as Promise’s and BSC’s business units.
- Will work closely with the companies Compliance team on regulatory issues.
- 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.
Knowledge and Experience:
- 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 uncertainty 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.
Qualifications – External Requirements:
- Seven or more years of relevant legal experience. Expertise providing managed care legal advice to HMOs and/ or providers, with a focus on the Medicare and Medi-Cal programs preferred.
- Experience providing legal counsel on Medicare Part A and D and special needs/D-SNP programs.
- Experience managing outside counsel preferred.
- Knowledge of the Knox-Keene Health Care Service Plan Act and Regulations, Affordable Care Act, HIPAA, Stark laws, and False Claims Act.
- Strong ability to provide risk assessment/ risk mitigation support.
- Experience working with Regulatory agencies including DHCS, CMS, DMHC along with county organizations and Local Initiatives.
- Combination of law firm and in-house experience preferred.
- JD from a respected law school and Bar admission (CA preferred).
To apply, please submit the online application form, available at: https://bsc.referrals.selectminds.com/bsc/jobs/senior-director-legal-counsel-1709