Associate General Counsel, Distinguished - Dispute Resolution

Blue Shield of California•Oakland, CA

About The Position

Your Role The Associate General Counsel, Dispute Resolution (“AGC”) will provide strategic advice and counsel, as well as legal representation on a broad range of health care disputes and issues, with a particular focus on defending payor-provider arbitrations, regulatory enforcement actions (including responding to subpoenas and investigations), and health care litigation. 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 comprises 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, directly represent and advocate for the company in arbitration and enforcement settings, master new responsibilities, effectively advise business clients in a dynamic business and legal environment, and possess a strong drive for excellence.

Requirements

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 required; superior academic credentials from a top-tier law school strongly preferred.
Requires one to be an active member of the California Bar.
Requires knowledge and recent experience providing actionable legal advice to business clients related to the Knox-Keene Act, other state and federal laws impacting health plans, and member and provider contracts.
Requires at least 8 years of litigation experience, at least 5 of which include recent experience defending health plans, health insurers, or HMOs in litigation, arbitration, government investigations, subpoena responses, and other formal or informal disputes.
Requires recent trial and/or arbitration hearing experience.
Requires one to be 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.
Requires experience with contracted and non-contracted provider payment disputes.

Nice To Haves

Combination of law firm and in-house experience preferred.

Responsibilities

Directly (first-chair) defend Blue Shield of California in arbitration and regulatory enforcement matters.
Defend Blue Shield of California against arbitrations, regulatory enforcement matters, investigations, subpoena response, and litigation by supervising the work of outside legal counsel.
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.
In consultation with Law Department leaders and the EVP/GC, establish legal policy and standards for the enterprise, and for the business and functional units served by the AGC.
Manage the work of paralegals and litigation specialists assigned to your matters.
Work collaboratively with other attorneys, paralegals, and litigation specialists.
Provide guidance and training to Blue Shield of California’s highly capable and valued legal support professionals.
Pursue litigation, arbitration, and recovery actions.
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.
Other duties, as assigned.