Associate General Counsel, Sr Principal - Appeals and Grievances

Blue Shield of CA; Oakland (CA); Hybrid; USD 180,000 - 260,000; Full time

Job summary

Blue Shield of California seeks an Associate General Counsel, Sr. Principal to support the Appeals and Grievances Department, working with state regulators on member appeal cases and policy initiatives affecting customer service outcomes.

The role demands extensive regulatory expertise, collaboration with internal teams and regulators, and a proven ability to deliver high-quality legal guidance in a fast-paced health care environment. Hybrid work model.

Qualifications

• Requires a juris doctorate degree from an ABA-accredited law school.
• Active California Bar member or in-house counsel status with State Bar of California.
• Minimum five years providing legal advice in health care regulation, corporate, privacy, or contracts.
• Excellent written and verbal communication and stakeholder relationship skills.
• Strong independent judgment, problem-solving, integrity.
• Ability to work with minimal supervision in a regulated environment.
• Ability to lead and work independently or on teams.
• Proficiency with Word, Excel, PowerPoint, Outlook.
• Experience in law firms, in-house health law, or state regulator work preferred.

Responsibilities

• Support Appeals and Grievances Department in its interactions with state regulators.
• Provide legal support for operational and policy projects related to customer service outcomes from member appeals.
• Communicate complex legal issues to non-lawyer clients and regulator staff.

Skills

Juris Doctorate

California Bar

Legal Advisory

Regulatory Expertise

Communication Skills

Independent Judgment

Legal Writing

Team Leadership

Education

Juris Doctorate (J.D.)

Tools

Microsoft Word

Excel

PowerPoint

Outlook

Job description

Your Role

The Medical Care Solutions team is responsible for various client support within Blue Shield of California, including the Appeals and Grievances Department and Customer Service Team, Behavioral Health, Medical Policy, Utilization Management, Pharmacy and Regulatory Filings. The Associate General Counsel, Sr. Principal, will report to the Managing Senior Director. In this role you will support the Appeals and Grievances Department in its interactions with state regulators, specifically by assisting with cases related to member appeals of health plan denials and provide legal support for operational and policy projects related to customer service outcomes from member appeals.

Your Knowledge and Experience

• Requires a juris doctorate degree from a law school accredited by the American Bar Association or Committee of Bar Examiners of the State of California
• Requires active member of the California bar, or active licensee in good standing of a bar of a United States state or the District of Columbia who maintains Registered In-House Counsel status with the State Bar of California
• Requires a successful track record of at least five 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 law firm or in-house health law department, including state or federal regulatory agency
• 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 required
• Requires ability to lead when appropriate and to work both independently and collaboratively on teams
• Requires proficiency in Microsoft Word, Excel, PowerPoint, and Outlook
• Requires ability to communicate complex legal issues to non-lawyer clients and regulator staff
• A combination of law firm, in-house counsel and/or state regulator experience is preferred

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.