Associate General Counsel (Managed Care, Provider Network, Medicaid) - Hybrid
Blue Cross Blue Shield of ArizonaAbout the role
Awarded a Healthiest Employer, Blue Cross Blue Shield of Arizona aims to fulfill its mission to inspire health and make it easy. AZ Blue offers a variety of health insurance products and services to meet the diverse needs of individuals, families, and small and large businesses as well as providing information and tools to help individuals make better health decisions.
At AZ Blue, we have a hybrid workforce strategy, called Workability, that offers flexibility with how and where employees work. Our positions are classified as hybrid, onsite or remote. While the majority of our employees are hybrid, the following classifications drive our current minimum onsite requirements:
Hybrid People Leaders: must reside in AZ, required to be onsite at least twice per week
Hybrid Individual Contributors: must reside in AZ, unless otherwise cited within this posting, required to be onsite at least once per week
Hybrid 2 (Operational Roles such as but not limited to: Customer Service, Claims Processors, and Correspondence positions): must reside in AZ, unless otherwise cited within this posting, required to be onsite at least once per month
Onsite: daily onsite requirement based on the essential functions of the job
Remote: not held to onsite requirements, however, leadership can request presence onsite for business reasons including but not limited to staff meetings, one-on-ones, training, and team building
Please note that onsite requirements may change in the future, based on business need, and job responsibilities. Most employees should expect onsite requirements and at a minimum of once per week.
This position is hybrid within the state of AZ only. This hybrid work opportunity requires residency, and work to be performed, within the State of Arizona.
PURPOSE OF THE JOB
- 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.
REQUIRED QUALIFICATIONS
Required Work Experience
- 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
Required Education
- Juris Doctorate from an ABA Approved Law School
Required Licenses
- 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.
Required Certifications
- Admission to a State Bar, with evantual admission to State Bar of Arizona
PREFERRED QUALIFICATIONS
Preferred Work Experience- Experience with the No Surprises Act
- Experience with Mental Health Parity
- Experience with grievances and appeals
- N/A
- N/A
- N/A
ESSENTIAL JOB FUNCTIONS AND 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
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