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Associate General Counsel - Care1st Health Plan Job
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| Employer Name: |
SpiderID: 13751924 |
| Location: San Francisco, California |
Date Posted: 5/22/2024 |
| Wage: Negotiable |
Category: Insurance |
| Job Code: 17001P7-2191 |
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Job Description:
 Looking for a chance to do meaningful work that touches millions? Come join the hardest working, nonprofit health plan in California and help us shape the future of health care. Blue Shield of California is focused on transforming health care by making it more accessible, affordable and customer-centric. Being a mission-driven organization means we do much more than serve our 3.5 million members: we were the first health plan in the nation to limit our annual net income to 2 percent of revenue and return the difference to our customers and the community, and since 2005 we have contributed more than million to the Blue Shield of California Foundation to improve community health and end domestic violence. We also believe that a healthier California begins with our employees, so we provide them with resources to develop and maintain a healthy lifestyle through our award-winning wellness program, Wellvolution.
We're hiring smart thinkers and doers who want to work for a leader and innovator in the challenging, ever-changing healthcare space. Come and help us make health care better for everyone.
Description:
Associate General Counsel
Focus Area: Government Sponsored Programs, Care1st Health Plan
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 Care1st subsidiary, which operates Medicare and Medi-Cal (Medicaid) 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 BSC and Care1st business units
- 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:
- Seven or more years of legal experience. Expertise providing managed care legal advice to HMOs 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, 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
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 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 judgement 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
Job Criteria:
Start Date:
Position Type: Full-Time Permanent
Years of Experience Required:
Education Required:
Overnight Travel:
Vacation Time:
Contact Information:
| Contact Name: Blue Shield of California |
Company Type: |
| Company: Blue Shield of California |
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