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Senior Compliance Consultant Job
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| Employer Name: |
SpiderID: 13775241 |
| Location: Monterey Park, California |
Date Posted: 6/21/2024 |
| Wage: Negotiable |
Category: Insurance |
| Job Code: 17002A6-2191 |
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Job Description:
 Looking for a chance to do meaningful work that touches millions? Come join the hardest working, nonprofit health plan in California and help us shape the future of health care. Blue Shield of California's Mission is to ensure all Californians have access to high-quality care at an affordable price. Blue Shield is focused on improving health care delivery by working closely with providers and making it more accessible, affordable and customer-centric. Being a mission-driven organization means we do much more than serve our 4 million members: we were the first health plan in the nation to limit our annual net income to 2 percent of revenue and return the difference to our customers and the community, and since 2005 we have contributed more than $325 million to the Blue Shield of California Foundation to improve community health and end domestic violence. We also believe that a healthier California begins with our employees, so we provide them with resources to develop and maintain a healthy lifestyle through our award-winning wellness program, Wellvolution.
We're hiring smart thinkers and doers who want to work for a leader and innovator in the challenging, ever-changing healthcare space. Come and help us make health care better for everyone.
Description:
Key Responsibilities:
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Responsible for intake, creation, development and communication, and obtaining stakeholder approval of Work Orders for low to medium complexity mandates
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Facilitates and manages cross-functional impact assessments with business area and functional unit stakeholders
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Develops, documents and maintains mandate intake and/or compliance verification status in inventory
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Prepares low to medium complexity audit analyses, reports and recommendations for corrective action to management.
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Support the implementation of a high quality, repeatable and documented mandate compliance monitoring process
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Works with limited guidance to conduct formal compliance verification and remediation of low to medium risk mandates
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Escalate gaps to Sr. Manager(s), Director and/or Sr. Director with recommendations for resolution
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Develops, prepares and presents low complexity analyses and/or reports to Management
Support other MCG initiatives and projects as delegated by Mandates Control Group management
Qualifications:
Education/Requirements:
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Requires Bachelor's degree or equivalent of six years relevant experience and/or training, or equivalent combination of education and experience
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Experience working in the healthcare industry, in a compliance role or internal audit, quality and/or risk management
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Knowledge of mandates, health insurance operations, ACA legislation requirements and broad knowledge of the industry and environment within and outside of BSC.
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Advanced knowledge of and ability to perform analyses such as GAP, process mapping, root-cause, risk, and requirements data gathering.
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Adaptable and willing to work in fluid business situations.
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Excellent written and spoken communication skills. Ability to communicate effectively --- from front line staff up through senior leadership
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Demonstrated experience collaborating and negotiating with managers and executives.
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Demonstrated strengths at working on high profile, urgent projects.
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Advanced project management skills
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Able to work in a fast-paced environment
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Drive for results
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Strong sense of integrity/ethics/trust.
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Adaptable and willing to work in fluid business situ
Polished and professional demeanor and appearance.
Job Criteria:
Start Date:
Position Type: Full-Time Permanent
Years of Experience Required:
Education Required:
Overnight Travel:
Vacation Time:
Contact Information:
| Contact Name: Blue Shield of California |
Company Type: |
| Company: Blue Shield of California |
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