Sr. Director, Legal Counsel-Health Law

Min 10 yrs required

Full-time

No

# Sr. Director, Legal Counsel-Health Law

## Overview

Blue Shield of California’s mission is to ensure all Californians have access to high-quality health care at a sustainably affordable price. The Sr. Director, Legal Counsel will be a member of Blue Shield’s Law Department and will be a leader in the company. The Law Department partners with the company’s business leaders to embrace legal and ethical behavior in the achievement of the company’s mission. This team is highly regarded within the company and respected by management.

## Your Role

The Sr. Director, Legal Counsel will 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 compensation methodologies including global and shared risk arrangements, developing model provider agreements, and supporting the provider delegation oversight team. The Sr. Director, Legal Counsel also will engage with key regulators on filings and needed approvals. The Sr. Director, Legal Counsel must comfortably adapt to change, skillfully and quickly master new responsibilities, have demonstrated a strong business acumen, be able to lead team members, and possess a strong drive for excellence.

## Your Work

In 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 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

### Your Knowledge and Experience

- Requires a 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
- Requires 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. Ideally, the candidate will possess a combination of law firm and in-house experience
- 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 required
- 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 required
- 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 preferred
- Experience drafting and negotiating complex contracts between health plans and health care providers, including major provider systems and virtual providers preferred
- Superior contracting skills, and an ability to assess and draft agreements with a complete understanding of ramifications integrating law and business preferred
- 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 preferred
- 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 preferred
- 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.

## About Blue Shield

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 genuinely 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

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