Associate General Counsel, Distinguished

Blue Shield of California; Oakland (CA); Hybrid; USD 250,000 - 420,000; Full time

Job summary

Blue Shield of California’s Government Programs Legal team seeks an Associate General Counsel, Distinguished, to advise on health-law matters impacting Medicare, Medi-Cal, and DSNP. You will work with Promise Health Plan, oversee outside counsel, manage regulatory filings, and partner with Compliance to support day-to-day operations.

The role requires a JD, active CA bar (or eligibility for in-house status), and at least eight years of relevant experience in a regulated health-care environment,

Qualifications

• Requires a Juris Doctorate from an ABA-accredited law school.
• Requires active California bar membership or eligibility for in-house status.
• Requires 8+ years of legal advisory experience in health care, corporate, or regulatory areas.

Responsibilities

• Research and advise on legal, regulatory, and contractual matters for government program lines (Medicare, Medi-Cal, DSNP).
• Manage outside counsel and budgets; review vendor agreements for government lines.
• Support regulatory filings and coordinate with Compliance teams; assist in strategic projects for government programs.

Skills

Regulatory Compliance

Health Law

Stakeholder Management

Regulatory Filings

Contract Review

Legal Research

Education

Juris Doctorate

Active CA Bar

Job description

Description

Your Role

The Government Programs Legal team is responsible for supporting all government programs lines of business. The Associate General Counsel, Distinguished, will report to the Managing Associate General Counsel, Government Programs. In this role you will provide advice and counsel on a broad range of health law issues impacting Blue Shield of California and Promise Health Plan’s government programs lines of business. These programs include Medicare, Medi-CaI (Medicaid), and Duals Special Needs Plans (DSNP). The AGC must comfortably adapt to change, skillfully and quickly master new responsibilities, demonstrate strong business acumen, and possess a strong drive for excellence. In this role, the AGC will be responsible for working on regulatory filings for Promise Health Plan, supporting day-to-day operations of the Medicare and Medi-Cal lines of business, and working with the Compliance teams to provide legal support.

Responsibilities

Your Work

In this role, you will:

• Research and advise all levels of the company on legal, regulatory, and contractual matters for the government lines of business which include Medi-Cal and Medicare
• Manage the work of outside counsel and ensure adherence to outside counsel budget
• Review and advise on vendor agreements for Blue Shield's Medicare line of business and Promise Health Plan's Medi-Cal line of business and support key regulatory filings for those lines of business
• Create, foster, and maintain relationships with internaland constituents that enhance the Company’s reputation as a health plan, employer, and corporate citizenship
• Work directly with Medicare and Medi-Cal Compliance teams to provide legal and regulatory guidance on regulatory audits and notifications to regulators
• Advise Medicare and Medi-Cal business units on strategic projects and initiatives
• Work with Law Department leadership to define and execute on Law Department operational plans
• Support the Network Legal Team for the government programs lines of business to ensure regulatory requirements are met when contracting with providers
• Other duties, as assigned.

Qualifications

Your Knowledge and Experience

• Requires a Juris doctorate degree from a law school accredited by the American Bar Association
• Requires one to be an active member in good standing of the California bar, or active licensee in good standing of the bar of any state of the United States or the District of Columbia who maintains or is eligible to obtain Registered In‑House Counsel status with the State Bar of California
• Requires a successful track record of at least 8 years of experience providing legal advice on relevant areas of the law (e.g., corporate, privacy, health care regulatory, litigation, contracts, et al) at a top law firm or in‑house corporate law department
• Requires excellent communication skills, both written and verbal, as well as relationship building skills to collaborate with and influence all relevant stakeholders, both internal and external
• Requires strong independent judgment, problem‑solving, critical, and analytical thinking skills, including a “moral compass” and high integrity
• Requires ability to work with minimal supervision, to multi‑task, and to deliver a high‑quality work product in a highly regulated, demanding, and constantly changing corporate environment
• Requires ability to lead individuals and teams and to work both independently and collaboratively on teams, applying people management and mentoring skills
• Requires expertise providing legal advice to managed care organizations, preferably with a focus on Medicare, Medi-Cal and DSNP
• Requires knowledge of the Knox‑Keene Health Care Service Plan Act and understanding of Medicare rules and regulations (CMS), Department of Health Care Services contract and associated all plan letters (Medi‑Cal)
• Requires experience providing interpretation and analysis of statutes, regulations and sub‑regulatory guidance
• Requires experience interacting and working with the Department of Managed Health Care as well as providing clients with regulatory advice on Department filings
• Requires strong ability to provide risk assessment/risk mitigation support

Hybrid

This role requires employees to be in‑office based on our hybrid workplace model, balancing purposeful in‑person collaboration with flexibility. For most teams, this means coming into the office two days each week.

Employees living more than 50 miles from an office location will work with their manager to determine in‑office time based on business need.