Quick overview
Job 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.
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 internal and 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.
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.
Similar jobs
- CI
On-Call Rigging Technician - KÀRecently posted Auto Apply
Cirquedusoleil · Las Vegas · On-site 🇺🇸
Microsoft ExcelMicrosoft OfficeAutoCAD+2Salary not listed - TR
Multi-scale Physics Battery Modeling InternRecently posted Auto Apply
Tri · Los Altos · Hybrid 🇺🇸
RoboticsPythonData AnalysisSalary not listed - TR
Accelerated Science Intern, Representation Learning for Molecules and MaterialsRecently posted Auto Apply
Tri · Los Altos · Hybrid 🇺🇸
LinearRoboticsPyTorch+2Salary not listed - SF

Museum Prep I, On-CallRecently posted Auto Apply
Sfmoma · South San Francisco · On-site 🇺🇸
Diversity & Inclusion$32 - $38/hr - FL

College Admissions CounselorRecently posted Auto Apply
Floowi · United States · Remote 🇺🇸
Google WorkspaceSlackZoomSalary not listed - DH

Charge Analysis AssociateRecently posted Auto Apply
Dreem Health · United States - Remote · Remote 🇺🇸
ICD-10Medical BillingSalary not listed - NE
Senior Performance Creative StrategistRecently posted Auto Apply
Newform · New York City · Hybrid 🇺🇸
Salary not listed - PP
Director of Health Center Operations Auto Apply
Pplm · Boston · On-site 🇺🇸
Complaint ResolutionComplianceContinuous Improvement+5$102k - $130k/yr - WE

Quality TechnicianRecently posted Auto Apply
Westmag · South San Francisco · On-site 🇺🇸
DroneERPSalary not listed - IT

Associate Director/Director, Quality Management Systems (QMS)Recently posted Auto Apply
Immunic Therapeutics · Remote - US · Remote 🇺🇸
ComplianceInternal AuditLMS+4Salary not listed - LI

Join Our Talent Community-Child Care DirectorRecently posted Auto Apply
Littlesprouts · Lawrence · On-site 🇺🇸
RecruitingOnboardingWorkday+8$72.5k - $93.2k/yr - GE
In-House CreatorRecently posted Auto Apply
Genesis · Bay Area · On-site 🇺🇸
RoboticsPremiere ProCapCutSalary not listed