Associate General Counsel (Managed Care, Provider Network, Medicaid) - Hybrid

Blue Cross Blue Shield of Arizona•Phoenix, AZ

12d•Hybrid

About The Position

AZ Blue is seeking a dynamic attorney with broad skills to provide strategic and practical in-house counsel to support enterprise provider network contracting and disputes, grievances and appeals, and the Medicaid segment. The successful candidate will serve as a trusted legal advisor for provider issues across all lines of business as well as for Medicaid regulatory compliance and operational risk.

Requirements

6 years of progressively responsible legal experience
3 years of experience in healthcare regulatory work and/or healthcare related corporate or government agency work, with meaningful exposure to managed care operations, provider contracting, and Medicaid regulatory requirements.
Experience directly advising business stakeholders
Strong skills in issue spotting in a complex regulatory environment
Juris Doctorate from an ABA Approved Law School
Active, current, and unrestricted license to practice law in the State of Arizona, or licensure in another jurisdiction and ability to become licensed to practice law in the State of Arizona.
Admission to a State Bar, with eventual admission to State Bar of Arizona
Intermediate skill in use of modern technology
Intermediate PC proficiency
Intermediate proficiency in spreadsheet, database, and word processing
Maintain confidentiality and privacy
Analytical knowledge necessary to generate reports based on available data and then make decisions based on reported data
Capable of legal and analytical research
Practice interpersonal and active listening to achieve high customer satisfaction and departmental communication standards
Establish and maintain working relationships in a collaborative team environment – being a team player
Make use of employees' skills and abilities to deliver business objectives

Nice To Haves

Experience with the No Surprises Act
Experience with Mental Health Parity
Experience with grievances and appeals
Knowledge of a wide range of subjects pertaining to the organization's services and operations.

Responsibilities

Provide support to provider network teams for all lines of business across the enterprise, advising on provider contracts and negotiations, provider disputes, and related regulatory schemes
Provide strategic legal counsel to the Medicaid segment, advising on regulatory compliance, reimbursement frameworks, and operational risk, while partnering with business leaders to enable compliant growth and innovation
Assist with legal issues arising from grievance and appeals team
Supervise responses to regulatory, attorney, provider, and member complaints, including drafting responses, reviewing responses drafted by paralegal and/or research assistants, and consulting with other BCBSAZ employees on responses.
In a timely and efficient manner, provide guidance to business leads on regulatory and statutory requirements, including new rules and legislative bills, and the related impact to operations
Serve as a trusted advisor to internal clients and leadership
Deliver training and guidance on legal and regulatory topics
Work cooperatively with other BCBSAZ teams such as compliance, audit and enterprise risk
Perform all other duties as assigned.