The hiring range for this role is:  

92,086.00 - 129,145.00

Job Description Summary:

This role serves as the primary internal resource to the Ethics and Compliance Official on compliance matters, and as an information resource to BCBS Plans and other external and internal stakeholders. Leads internal and external compliance-related training programs, including required ethics training and conflicts of interest process. Leads Plan compliance activities including monthly calls, roundtables, national teleconferences, and annual conferences. Establishes and maintains productive relationships with both internal and Plan senior staff to build consensus and provide solutions and training support for emerging compliance issues. Facilitates the sharing of best practices between the Plans and business partners on compliance activities.

Responsibilities include but are not limited to:

• Serves as the Ethics and Compliance Official’s primary support for the BCBSA Ethics & Compliance Program. Leads internal and external compliance requirements, including new hire ethics training, annual ethics refresher training, new-hire conflict of interest process, annual conflicts of interest process, and the annual ethics awareness event.

• Leads the coordination and hosting of educational programming for Blue Plan compliance and ethics professionals, including monthly and bi-monthly calls. Plans and coordinates the Compliance and Ethics track at the Annual BCBSA Law, Audit, Compliance & Ethics Conference, including roundtables and mini-conferences. Researches industry issues, develops agendas, procures speakers, coordinates vendors, supervises event administration, and secures Continuing Education credits for all events.

• Serves as the main resource for Plan Compliance and Ethics professionals at the Association, collaborating with Plans to address information requests and locate subject matter experts. Partners with BCBSA business and policy teams to develop programs and identify vendor opportunities, acting as a liaison for national purchasing contracts. Analyzes confidential data to create resources for Plans and conducts surveys for Blue Plan leadership.

• Responsible for daily monitoring of the BCBSA Compliance Officer and Ethics shared mailboxes and responding as appropriate to requests. Monitors Compliance Line and assists in compliance investigations.

• Manages and organizes databases, education resources, and listservs for Compliance & Ethics. Maintains an active calendar of events and a database of Plan Compliance and Ethics departments. Coordinates all key department electronic services and maintains the resource and document repository on PlanConnexion.

Required Education, Certifications and Experience:

Education:

• Required - Bachelors degree

Experience:

• Required: A minimum of five (5) years of relevant compliance and ethics experience, preferably in a healthcare or managed care environment.
• Required: Experience in the interpretation and application of federal and state regulations, policies and procedures, and ethical principles related to healthcare compliance.

Preferred:

• Experience with BCBS systems/applications.
• Experience with Liferay and other web publishing tools.

Certification:

• Certified Compliance & Ethics Professional Certification (CCEP) - Compliance Certification Board - Preferred

• Certified in Healthcare Compliance (CHC) - Compliance Certification Board - Preferred

• Leadership Professional in Ethics & Compliance (LPEC) - Ethics and Compliance Institute - Preferred

Knowledge, Skills, and Abilities:

• Strong understanding of best practices in internal ethics and compliance programs.

• Strong organization and prioritization skills. Adept at managing a high volume of work with changing priorities.

• Critical thinking skills and the ability to apply an analytical approach to research and issue remediation.

• Persuasion/negotiation and interpersonal relationship skills and the ability to effectively interact and collaborate with individuals at all levels within the organization.

• High level problem solving acumen. Ability to identify potential noncompliance issues, obtain information to clarify and describe issue, exercise sound decision-making, resolve problems using appropriate risk treatment, and leverage appropriate escalation pathways.

• Strong knowledge of MS Office platform including the ability to effectively utilize PowerPoint and Word to prepare presentations and reports.

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