Compliance Specialist II
About The Position
Blue Cross of Idaho is seeking a Compliance Specialist to perform general functions such as: Regulatory analysis Leading or coordinating compliance risk assessments Auditing and monitoring of adherence to compliance requirements Design and delivery of compliance education Distribution of compliance communications Coordination of policy authoring/updates Advising business areas of their compliance obligations. Compliance issue resolution We're seeking for a Specialist with: Experience: 4 years’ health industry, internal audit, legal, compliance, or government programs (8 years of experience if candidate does not have Bachelor’s degree) Education: Bachelor’s Degree or equivalent work experience (Two years’ relevant work experience is equivalent to one-year college) Your day may look like: Analyze and distribute new and updated regulatory requirements to pertinent business areas. Support and coordinate audits of Blue Cross of Idaho’s products and services. Coordinate the resolution of compliance issues that emerge. Develop training/education and communications for individual departments and the organization as a whole Perform monitoring and auditing of adherence to program requirements Maintains and applies knowledge of regulations and regulatory changes relevant to the industry and the organization – CMS, Department of Labor, Department of Insurance, and others Supports and/or coordinates external audits of BCI undertaken by external government regulators. Acts as a subject matter expert for regulatory requirements pertaining to BCI commercial products. Ensures regulatory standards are applied to organizational policies and procedures by evaluating and communicating regulatory guidance to impacted business areas. Performs periodic risk assessments on operational areas with regulatory lines of business and contributes to monitoring and auditing workplans. Responds to compliance and privacy related questions, complaints, and incidences. Investigates and risk-ranks reported compliance issues. Works with business and process owners to develop corrective action plans that effectively remediate issues and prevent future occurrences. Facilitates or supports organizational compliance training on general compliance and other topics required by regulation. Conducts monitoring, auditing and surveillance of operational functions, reports results to business process owners, and takes compliance actions in response to findings. Analyzes monitoring and surveillance results that are reported to compliance by business areas. Works with business relationship owners and vendors to train, educate, mitigate compliance risks, and drive industry best practices. Performs other duties and responsibilities as assigned.
Requirements
- Experience: 4 years’ health industry, internal audit, legal, compliance, or government programs (8 years of experience if candidate does not have Bachelor’s degree)
- Education: Bachelor’s Degree or equivalent work experience (Two years’ relevant work experience is equivalent to one-year college)
Responsibilities
- Analyze and distribute new and updated regulatory requirements to pertinent business areas.
- Support and coordinate audits of Blue Cross of Idaho’s products and services.
- Coordinate the resolution of compliance issues that emerge.
- Develop training/education and communications for individual departments and the organization as a whole
- Perform monitoring and auditing of adherence to program requirements
- Maintains and applies knowledge of regulations and regulatory changes relevant to the industry and the organization – CMS, Department of Labor, Department of Insurance, and others
- Supports and/or coordinates external audits of BCI undertaken by external government regulators.
- Acts as a subject matter expert for regulatory requirements pertaining to BCI commercial products.
- Ensures regulatory standards are applied to organizational policies and procedures by evaluating and communicating regulatory guidance to impacted business areas.
- Performs periodic risk assessments on operational areas with regulatory lines of business and contributes to monitoring and auditing workplans.
- Responds to compliance and privacy related questions, complaints, and incidences.
- Investigates and risk-ranks reported compliance issues.
- Works with business and process owners to develop corrective action plans that effectively remediate issues and prevent future occurrences.
- Facilitates or supports organizational compliance training on general compliance and other topics required by regulation.
- Conducts monitoring, auditing and surveillance of operational functions, reports results to business process owners, and takes compliance actions in response to findings.
- Analyzes monitoring and surveillance results that are reported to compliance by business areas.
- Works with business relationship owners and vendors to train, educate, mitigate compliance risks, and drive industry best practices.
- Performs other duties and responsibilities as assigned.
Benefits
- We offer a robust package of benefits including paid time off, paid holidays, community service and self-care days, medical/dental/vision/pharmacy insurance, 401(k) matching and non-contributory plan, life insurance, short and long term disability, education reimbursement, employee assistance plan (EAP), adoption assistance program and paid family leave program.
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What This Job Offers
Job Type
Full-time
Career Level
Mid Level
Number of Employees
1,001-5,000 employees
