Associate General Counsel (Managed Care, Provider Network, Medicaid) - Hybrid

Awarded a Healthiest Employer, Blue Cross Blue Shield of Arizona aims to fulfill its mission to inspire health and make it easy.AZ Blue offersa 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

Preferred Education

• N/A

Preferred Licenses

• N/A

Preferred Certifications

• 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 with other BCBSAZ teams such as compliance, audit and enterprise risk

• The position requires a full-time work schedule in a hybrid work environment. Full-time is defined as working at least 40 hours per week, plus any additional hours as requested or as needed to meet business requirements. Hybrid means that a portion of the work week will be hours spent in the office and not virtual.
• Perform all other duties as assigned.

REQUIRED COMPETENCIES

Required Job Skills

• Intermediate skill in use of modern technology
• Intermediate PC proficiency
• Intermediate proficiency in spreadsheet, database, and word processing

Required Professional Competencies

• Maintain confidentiality and privacy
• Analytical knowledge necessary to generate reports based on available data and then make decisions based on reported data
• Capable of legal and analytical research
• Practice interpersonal and active listening to achieve high customer satisfaction and departmental communication standards
• Establish and maintain working relationships in a collaborative team environment – being a team player

Required Leadership Experience and Competencies

• Make use of employees' skills and abilities to deliver business objectives

PREFERRED COMPETENCIES

Preferred Job Skills

• N/A

Preferred Professional Competencies

• Knowledge of a wide range of subjects pertaining to the organization's services and operations.

Preferred Leadership Experience and Competencies

• N/A

Our Commitment

AZ Blue does not discriminate in hiring or employment on the basis of race, ethnicity, color, religion, sex, sexual orientation, gender identity, national origin, age, disability, protected veteran status or any other protected group.