Associate General Counsel, Sr Principal - Appeals and Grievances

Your Role

The Medical Care Solutions team is responsible for various client support within Blue Shield of California, including the Appeals and Grievances Department and Customer Service Team, Behavioral Health, Medical Policy, Utilization Management, Pharmacy and Regulatory Filings. The Associate General Counsel, Sr. Principal, will report to the Managing Senior Director. In this role you will support the Appeals and Grievances Department in its interactions with state regulators, specifically by assisting with cases related to member appeals of health plan denials and provide legal support for operational and policy projects related to customer service outcomes from member appeals.

Your Knowledge and Experience

• 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
• Requires active member of the California bar, or active licensee in good standing of a bar of a United States state or the District of Columbia who maintains Registered In-House Counsel status with the State Bar of California
• Requires a successful track record of at least five 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 law firm or in-house health law department, including state or federal regulatory agency
• 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 required
• Requires ability to lead when appropriate and to work both independently and collaboratively on teams
• Requires proficiency in Microsoft Word, Excel, PowerPoint, and Outlook
• Requires ability to communicate complex legal issues to non-lawyer clients and regulator staff
• A combination of law firm, in-house counsel and/or state regulator experience is preferred

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.