Government Programs Compliance Specialist, Senior
About The Position
The Medicare Compliance team is responsible for providing oversight of Blue Shield’s Medicare Advantage and Part D plan operations to help ensure compliance with CMS regulations, contractual requirements, and internal policies. The Government Programs Compliance Specialist, Senior will report to the Senior Manager, Government Programs – Medicare Compliance. In this role, you will help support the effectiveness of the Medicare Compliance Program through risk-based monitoring, audits, and compliance activities that include evaluating the accuracy, completeness and integrity of plan materials, identifying compliance risks, and partnering with business teams to promote regulatory compliance and corrective action.
Requirements
- Report to the Senior Manager, Government Programs – Medicare Compliance.
Responsibilities
- Provide oversight of Blue Shield’s Medicare Advantage and Part D plan operations to ensure compliance with CMS regulations, contractual requirements, and internal policies.
- Support the effectiveness of the Medicare Compliance Program through risk-based monitoring, audits, and compliance activities.
- Evaluate the accuracy, completeness, and integrity of plan materials.
- Identify compliance risks.
- Partner with business teams to promote regulatory compliance and corrective action.
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What This Job Offers
Job Type
Full-time
Career Level
Senior
Education Level
No Education Listed
