Sr. Director, Legal Counsel-Health Law

Min 10 yrs required

Full-time

No

Sr. Director, Legal Counsel - Health Law

Blue Shield of California is seeking an experienced Sr. Director, Legal Counsel to provide advice and counsel on a broad range of health law issues. This position is a member of the company’s Law Department and will be a leader in the company. The Sr. Director, Legal Counsel is a highly regarded position within the company and respected by management.

Job Responsibilities:

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 Law Department managing attorneys, function as the general counsel of the business and functional units assigned, and coordinate all legal services required by those units as an integral member of the units’ leadership team
Design and implement policies, in consultation with the SVP/GC and Law Department leadership, governing Law Department organization, mission, strategy, and goals
Work with executives to develop Blue Shield vision and strategy
Provide advice and counsel on a broad range of health law issues, with a particular focus on strategic provider relationships, including negotiating contracts with major health systems for network participation, collaborating with business teams and members of the Law Department in developing innovative provider services agreements, accountable care organizations and specialty networks in Commercial, Medicare, and Medi-Cal programs, advising on a variety of provider compensation methodologies including global and shared risk arrangements, developing model provider agreements, and supporting the provider delegation oversight team
Advise at all levels within the company on legal, regulatory, governmental agency, and contractual matters having a material impact on Blue Shield's strategic, operational and reputational goals
Communicate with the Department of Managed Health Care, the California Department of Insurance, and the Department of Health Care Services to submit and seek approval of regulatory filings and responses

Qualifications:

Juris doctorate degree from a law school accredited by the American Bar Association
Must be an active member of the California bar, or have an active licensee in good standing of a bar of the United States or the District of Columbia who maintains Registered In-House Counsel status with the State Bar of California
Successful track record of at least 10 years of experience providing legal advice on relevant areas of the law (., corporate, privacy, health care regulatory, litigation, contracts, et al) at a top law firm or in-house corporate law department
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
Strong independent judgment, problem-solving, critical, and analytical thinking skills, including a “moral compass” and high integrity
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
Expertise providing legal advice to health plans, with a focus on managed care provider issues and provider-related regulatory requirements and operations in the Commercial, Medicare and Medi-Cal programs
Experience drafting and negotiating complex contracts between health plans and health care providers, including major provider systems and virtual providers
Superior contracting skills, and an ability to assess and draft agreements with a complete understanding of ramifications integrating law and business
Experience submitting and obtaining necessary approvals of regulatory filings with the Department of Managed Health Care, the California Department of Insurance, and the Department of Health Care Service
Knowledge of value-based compensation arrangements with providers, including compensation arrangements that take into account healthcare quality and equity measurements, and the ability to convert initial business concepts into compliant comprehensive contractual terms
Knowledge of the Knox-Keene Health Care Service Plan Act and Regulations, Affordable Care Act, ERISA, HIPAA, Stark laws, and False Claims Act

Pay Range:

The pay range for this role is: $ to $ for California.

Blue Shield of California is seeking a Sr. Director, Legal Counsel to provide advice and counsel on a broad range of health law issues. This position is a highly regarded position within the company and respected by management.

The Sr. Director, Legal Counsel will be responsible for:

Retaining, overseeing, and managing the work of outside counsel and ensuring adherence to outside counsel budget
Recommending 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
Functioning as the general counsel of the business and functional units assigned, and coordinating all legal services required by those units as an integral member of the units’ leadership team
Designing and implementing policies, in consultation with the SVP/GC and Law Department leadership, governing Law Department organization, mission, strategy, and goals
Working with executives to develop Blue Shield vision and strategy
Providing advice and counsel on a broad range of health law issues, with a particular focus on strategic provider relationships, including negotiating contracts with major health systems for network participation, collaborating with business teams and members of the Law Department in developing innovative provider services agreements, accountable care organizations and specialty networks in Commercial, Medicare, and Medi-Cal programs, advising on a variety of provider compensation methodologies including global and shared risk arrangements,

Legal