Sr. Director, Legal Counsel-Dispute Resolution and Government Programs
Company: Blue Shield of California
Location: Oakland
Posted on: July 30, 2022
Job Description:
Blue Shield of California's mission is to ensure all
Californians have access to high-quality health care at a
sustainably affordable price. We are transforming health care in a
way that truly serves our nonprofit mission by lowering costs,
improving quality, and enhancing the member and physician
experience.
To fulfill our mission, we must ensure a diverse, equitable, and
inclusive environment where all employees can be their authentic
selves and fully contribute to meet the needs of the multifaceted
communities we serve. Our comprehensive approach to diversity,
equity, and inclusion combines a focus on our people, processes,
and systems with a deep commitment to promoting social justice and
health equity through our products, business practices, and
presence as a corporate citizen.
Blue Shield has received awards and recognition for being a
certified Great Place to Work, best place to work for LGBTQ
equality, leading disability employer, one of the best companies
for women to advance, Bay Area's top companies in volunteering &
giving, and one of the world's most ethical companies. Here at Blue
Shield of California, we are striving to make a positive change
across our industry and the communities we live in - join us!
Your RoleThe Associate General Counsel, Dispute Resolution and
Government Programs ("AGC") will provide strategic advice and
counsel on a broad range of health care disputes and issues, with a
particular focus on health care litigation, provider arbitration,
regulatory enforcement actions, subpoenas, and investigations
related to government programs (Medicare and Medi-Cal). The ACG
will be the primary litigation attorney supporting Blue Shield of
California's and Blue Shield of California Promise Health Plan's
government programs lines of business, but will also manage
commercial disputes. The AGC will report to the Vice President,
Deputy General Counsel, Litigation. The Law Department partners
with the company's business leaders to embrace legal and ethical
behavior in the achievement of the company's mission. The
Litigation Group is highly regarded within the company and
respected by management. It is comprised of top tier, analytical,
ethical, collaborative and intelligent attorneys, paralegals,
litigation specialists, fraud investigators, and administrative
support staff. The AGC must comfortably adapt to change, lead with
influence, demonstrate strong business acumen, master new
responsibilities, effectively advise business clients in a dynamic
business and legal environment, and possess a strong drive for
excellence. This position will be hybrid within California.
Your WorkIn this role, you will:
- In consultation with appropriate Law Department leadership,
retain, oversee, and manage the work of outside counsel and ensure
adherence to outside counsel budget
- Recommend operational plans and strategies that directly impact
the achievement of overall results for multiple departments and
company-wide results, profitability, and/or public image of the
organization
- Under the direction of the Vice President, Deputy General
Counsel, coordinate all litigation and investigation-related legal
services required by Blue Shield of California Promise Health Plan
(the Company's Medi-Cal affiliate) and Blue Shield of California's
Medicare business as an integral member of the leadership
teams
- In consultation with Law Department leaders and the SVP/GC,
establish legal policy and standards for the enterprise, and for
the business and functional units served by the AGC
- Manage the paralegal assigned to government programs
litigation, arbitration, subpoenas, and regulatory enforcement
matters. Work collaboratively with other attorneys, paralegals and
litigation specialists specializing in commercial disputes. Provide
guidance and training to Blue Shield of California's highly capable
and valued legal support professionals
- Defend Blue Shield of California Promise Health Plan and Blue
Shield of California against litigation, arbitrations,
investigations, subpoena response, and regulatory enforcement
matters, in some cases directly, and in others, by supervising the
work of outside legal counsel
- Pursue litigation and recovery
- Engage with government agencies in connection with subpoenas,
enforcement actions, and investigatory demands. Partner with
internal clients and paralegals to respond to discovery requests
and investigatory demands.
- Provide timely, actionable advice and counsel to internal
clients, enabling them to achieve their goals within a prudent
range of legal risk, offering particular expertise in risks
associated with government programs (Medicare, Medi-Cal)
- Other duties, as assigned
Your Knowledge and Experience
- Juris doctorate degree required; superior academic credentials
from a top-tier law school strongly preferred
- Must have at least 10 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.
- Minimum of 8 years' litigation experience, at least 5 of which
include recent experience defending health plans, health insurers
or HMOs in litigation, arbitration, government investigations,
subpoena response, and other formal or informal disputes.
Combination of law firm and in-house experience preferred
- Active member of California State Bar
- Possess strong knowledge and recent experience, providing
actionable legal advice to business clients related to the
Knox-Keene Act, False Claims Act, Stark laws, Medicare Advantage,
Medicare Supplement, and Medi-Cal
- Demonstrated experience with contracted and non-contracted
provider payment disputes
- Self-motivated, enthusiastic, ethical, collaborative, and
hard-working. A successful candidate will have a "roll up your
sleeves" style and ability to partner and effectively communicate
with employees at all levels of the organization
- Requires strong written and oral communication skills,
analytical skills, intellectual curiosity, interest in diving into
the facts, and ability to meaningfully communicate with business
clients at all levels of the organization regarding complex legal
matters
Our Values
- Honest. We hold ourselves to the highest ethical and integrity
standards. We build trust by doing what we say we're going to do
and by acknowledging and correcting where we fall short
- Human. We strive to be our authentic selves, listening and
communicating effectively, and showing empathy towards others by
walking in their shoes
- Courageous. We stand up for what we believe in and are
committed to the hard work necessary to achieve our ambitious
goals
Keywords: Blue Shield of California, Oakland , Sr. Director, Legal Counsel-Dispute Resolution and Government Programs, Legal , Oakland, California
Didn't find what you're looking for? Search again!
Loading more jobs...