Government Programs Compliance Manager
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About The Position
The Compliance Manager position at BlueCross BlueShield of South Carolina is a pivotal role that focuses on developing and presenting compliance training, as well as researching, resolving, and tracking suspected compliance and privacy issues. This position provides guidance to management and employees, assists with various internal and external audits, and supplies information on compliance activities to the board of directors, executive management, and other internal and external sources as needed. The Compliance Manager will conduct annual risk assessments, conflict of interest reviews, and other mandated reviews by government oversight agencies. In this role, you will manage the development, implementation, and monitoring of compliance programs, which include adherence to the Health Insurance Portability and Accountability Act (HIPAA) privacy regulations, the Gramm-Leach-Bliley Act (GLBA), and the National Committee on Quality Assurance (NCQA) confidentiality requirements. You will also oversee all government program requirements, including internal control reviews, compliance audits, and investigations of compliance issues. Monitoring, recording, and tracking all potential and actual disclosures of Personally Identifiable Information (PII) and Protected Health Information (PHI) as required by various privacy and security laws will be a key responsibility. Additionally, the Compliance Manager will prepare and submit reports of disclosures to the Prime Contractor or appropriate government agency, maintain records on all incidents, and provide routine and ad hoc reports to management and government agencies. You will assist in developing and presenting ongoing compliance-related training to employees, including training on HIPAA privacy awareness. The role also involves administering annual compliance certification statements and compliance awareness surveys for government programs, investigating and following up on compliance issues, and preparing responses to inquiries from government and regulatory agencies. The Compliance Manager will also be involved in monitoring and following up on hotline reports and exit interviews, preparing information on division compliance activities, and completing required reports. There may be opportunities to assist in preparing documentation for regulatory approval for licensure and providing information for proposals related to business retention or new business opportunities.
