Your Role The Government Programs Legal team is responsible for supporting all government programs lines of business. The Associate General Counsel, Distinguished, will report to the Managing Associate General Counsel, Government Programs. In this role you will provide advice and counsel on a broad range of health law issues impacting Blue Shield of California and Promise Health Plan’s government programs lines of business. These programs include Medicare, Medi-CaI (Medicaid), and Duals Special Needs Plans (DSNP). The AGC must comfortably adapt to change, skillfully and quickly master new responsibilities, demonstrate strong business acumen, and possess a strong drive for excellence. In this role, the AGC will be responsible for working on regulatory filings for Promise Health Plan, supporting day-to-day operations of the Medicare and Medi-Cal lines of business, and working with the Compliance teams to provide legal support.
Your Work
In this role, you will:
- Research and advise all levels of the company on legal, regulatory, and contractual matters for the government lines of business which include Medi-Cal and Medicare
- Manage the work of outside counsel and ensure adherence to outside counsel budget
- Review and advise on vendor agreements for Blue Shield's Medicare line of business and Promise Health Plan's Medi-Cal line of business and support key regulatory filings for those lines of business
- Create, foster, and maintain relationships with internal and constituents that enhance the Company’s reputation as a health plan, employer, and corporate citizenship
- Work directly with Medicare and Medi-Cal Compliance teams to provide legal and regulatory guidance on regulatory audits and notifications to regulators
- Advise Medicare and Medi-Cal business units on strategic projects and initiatives
- Work with Law Department leadership to define and execute on Law Department operational plans
- Support the Network Legal Team for the government programs lines of business to ensure regulatory requirements are met when contracting with providers
- Other duties, as assigned.
Your Knowledge and Experience
- Requires a Juris doctorate degree from a law school accredited by the American Bar Association
- Requires one to be an active member in good standing of the California bar, or active licensee in good standing of the bar of any state of the United States or the District of Columbia who maintains or is eligible to obtain Registered In-House Counsel status with the State Bar of California
- Requires a successful track record of at least 8 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
- Requires 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
- Requires strong independent judgment, problem-solving, critical, and analytical thinking skills, including a “moral compass” and high integrity
- Requires 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
- Requires ability to lead individuals and teams and to work both independently and collaboratively on teams, applying people management and mentoring skills
- Requires expertise providing legal advice to managed care organizations, preferably with a focus on Medicare, Medi-Cal and DSNP
- Requires knowledge of the Knox-Keene Health Care Service Plan Act and understanding of Medicare rules and regulations (CMS), Department of Health Care Services contract and associated all plan letters (Medi-Cal)
- Requires experience providing interpretation and analysis of statutes, regulations and sub-regulatory guidance
- Requires experience interacting and working with the Department of Managed Health Care as well as providing clients with regulatory advice on Department filings
- Requires strong ability to provide risk assessment/risk mitigation support
Hybrid This role requires employees to be in-office based on our hybrid workplace model, balancing purposeful in-person collaboration with flexibility. For most teams, this means coming into the office two days each week.
Employees living more than 50 miles from an office location will work with their manager to determine in-office time based on business need.
About Blue Shield of California
As of January 2025, Blue Shield of California became a subsidiary of Ascendiun. Ascendiun is a nonprofit corporate entity that is the parent to a family of organizations including Blue Shield of California and its subsidiary, Blue Shield of California Promise Health Plan; Altais, a clinical services company; and Stellarus, a company designed to scale healthcare solutions. Together, these organizations are referred to as the Ascendiun Family of Companies.
At Blue Shield of California, our mission is to create a healthcare system worthy of our family and friends and sustainably affordable. 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 achieve our mission, we foster an environment where all employees can thrive and contribute fully to address the needs of the various communities we serve. We are committed to creating and maintaining a supportive workplace that upholds our values and advances our goals.
Blue Shield is a U.S. News Best Company to work for, a Deloitte U.S. Best Managed Company and a Top 100 Inspiring Workplace. We were recognized by Fair360 as a Top Regional Company, and one of the 50 most community-minded companies in the United States by Points of Light. Here at Blue Shield, we strive to make a positive change across our industry and communities – join us!
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 listen and communicate effectively, showing empathy by understanding others' perspectives.
- Courageous. We stand up for what we believe in and are committed to the hard work necessary to achieve our ambitious goals.
Our Workplace Model
We believe in fostering a workplace environment that balances purposeful in-person collaboration with flexibility - providing clear expectations while respecting the diverse needs of our workforce. Our workplace model is designed around intentional in-person interaction, collaboration, connection, creativity and flexibility:
• For most teams, this means coming into the office two days per week.
• Employees living more than 50 miles from an office location, out of state employees, and employees in certain member-facing roles should work with their manager to determine in-office time based on business need.
• For employees with medical conditions that may impact their ability to work in-office, we are committed to engaging in an interactive process and providing reasonable accommodations to ensure their work environment is conducive to their success and well-being.
The Company reserves the right to require more presence in the office based on business needs, and requirements are subject to change with periodic reviews.
Physical Requirements:
Office Environment - roles involving part to full time schedule in Office Environment. Based in our physical offices and work from home office/deskwork - Activity level: Sedentary, frequency most of work day.
Please click here for further physical requirement detail.
Equal Employment Opportunity:
External hires must pass a background check/drug screen. Qualified applicants with arrest records and/or conviction records will be considered for employment in a manner consistent with Federal, State and local laws, including but not limited to the San Francisco Fair Chance Ordinance. All qualified applicants will receive consideration for employment without regards to race, color, religion, sex, national origin, sexual orientation, gender identity, protected veteran status or disability status and any other classification protected by Federal, State and local laws.