Resolution Associate Jobs in Fairfield, CA (NOW HIRING)

Your Role

The Associate General Counsel, Dispute Resolution ("AGC") will provide strategic advice and counsel, as well as legal representation on a broad range of health care disputes and issues, with a particular focus on defending payor-provider arbitrations, regulatory enforcement actions (including responding to subpoenas and investigations), and health care litigation. The AGC will report to the Vice President, Deputy General Counsel, Litigation. 

The Law Department partners with the company's business leaders to embrace legal and ethical behavior in the achievement of the company's mission. The Litigation Group is highly regarded within the company and respected by management. It comprises top-tier, analytical, ethical, collaborative, and intelligent attorneys, paralegals, litigation specialists, fraud investigators, and administrative support staff. The AGC must comfortably adapt to change, lead with influence, demonstrate strong business acumen, directly represent and advocate for the company in arbitration and enforcement settings, master new responsibilities, effectively advise business clients in a dynamic business and legal environment, and possess a strong drive for excellence.

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. 

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.

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 required; superior academic credentials from a top-tier law school strongly preferred.

• Requires one to be an active member of the California Bar.

• Requires knowledge and recent experience providing actionable legal advice to business clients related to the Knox-Keene Act, other state and federal laws impacting health plans, and member and provider contracts. 

• Requires at least 8 years of litigation experience, at least 5 of which include recent experience defending health plans, health insurers, or HMOs in litigation, arbitration, government investigations, subpoena responses, and other formal or informal disputes. 

• Requires recent trial and/or arbitration hearing experience. 

• Requires one to be self-motivated, enthusiastic, ethical, collaborative, and hard-working. A successful candidate will have a "roll up your sleeves" style and ability to partner and effectively communicate with employees at all levels of the organization.

• Requires strong written and oral communication skills, analytical skills, intellectual curiosity, interest in diving into the facts, and ability to meaningfully communicate with business clients at all levels of the organization regarding complex legal matters.

• Requires experience with contracted and non-contracted provider payment disputes.

• Combination of law firm and in-house experience 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.

  
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Your Work

In this role, you will:

• Directly (first chair) defend Blue Shield of California in arbitration and regulatory enforcement matters. 

• Defend Blue Shield of California against arbitrations, regulatory enforcement matters, investigations, subpoena response, and litigation by supervising the work of outside legal counsel.

• 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. 

• In consultation with Law Department leaders and the EVP/GC, establish legal policy and standards for the enterprise, and for the business and functional units served by the AGC.

• Manage the work of paralegals and litigation specialists assigned to your matters. Work collaboratively with other attorneys, paralegals, and litigation specialists. Provide guidance and training to Blue Shield of California's highly capable and valued legal support professionals.

• Pursue litigation, arbitration, and recovery actions.

• Engage with government agencies in connection with subpoenas, enforcement actions, and investigatory demands. Partner with internal clients and paralegals to respond to discovery requests and investigatory demands. 

• Provide timely, actionable advice and counsel to internal clients, enabling them to achieve their goals within a prudent range of legal risk.

• Other duties, as assigned.