Blue Cross of Idaho
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Compliance Specialist II
role at
Blue Cross of Idaho .
Overview 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, and coordination of policy authoring/updates.
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.
Maintain and apply knowledge of regulations and regulatory changes relevant to the industry and the organization – CMS, Department of Labor, Department of Insurance, and others.
Support and/or coordinate external audits of BCI undertaken by external government regulators.
Act as a subject matter expert for regulatory requirements pertaining to BCI commercial products.
Ensure 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.
Respond to compliance and privacy related questions, complaints, and incidences. Investigate and risk-rank reported compliance issues. Work with business and process owners to develop corrective action plans that effectively remediate issues and prevent future occurrences.
Facilitate or support organizational compliance training on general compliance and other topics required by regulation.
Conduct monitoring, auditing and surveillance of operational functions, report results to business process owners, and take compliance actions in response to findings. Analyze monitoring and surveillance results that are reported to compliance by business areas.
Work with business relationship owners and vendors to train, educate, mitigate compliance risks, and drive industry best practices.
Perform other duties and responsibilities as assigned.
Qualifications
Experience: 4 years’ health industry, internal audit, legal, compliance, or government programs (8 years of experience if candidate does not have a Bachelor’s degree).
Education: Bachelor’s Degree or equivalent work experience (Two years’ relevant work experience is equivalent to one-year college).
Compensation As of the date of this posting, a good faith estimate of the current pay range is $78,064 to $117,095. The position is eligible for an annual incentive bonus (variable depending on company and employee performance).
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.
Reasonable Accommodations To perform this job successfully, an individual must be able to perform each essential duty satisfactorily. Reasonable accommodations may be made to enable individuals with disabilities to perform the essential functions.
Equal Opportunity Employer We are an Equal Opportunity Employer and do not discriminate against any employee or applicant for employment because of race, color, sex, age, national origin, religion, sexual orientation, gender identity, status as a veteran, and basis of disability or any other federal, state or local protected class.
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Compliance Specialist II
role at
Blue Cross of Idaho .
Overview 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, and coordination of policy authoring/updates.
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.
Maintain and apply knowledge of regulations and regulatory changes relevant to the industry and the organization – CMS, Department of Labor, Department of Insurance, and others.
Support and/or coordinate external audits of BCI undertaken by external government regulators.
Act as a subject matter expert for regulatory requirements pertaining to BCI commercial products.
Ensure 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.
Respond to compliance and privacy related questions, complaints, and incidences. Investigate and risk-rank reported compliance issues. Work with business and process owners to develop corrective action plans that effectively remediate issues and prevent future occurrences.
Facilitate or support organizational compliance training on general compliance and other topics required by regulation.
Conduct monitoring, auditing and surveillance of operational functions, report results to business process owners, and take compliance actions in response to findings. Analyze monitoring and surveillance results that are reported to compliance by business areas.
Work with business relationship owners and vendors to train, educate, mitigate compliance risks, and drive industry best practices.
Perform other duties and responsibilities as assigned.
Qualifications
Experience: 4 years’ health industry, internal audit, legal, compliance, or government programs (8 years of experience if candidate does not have a Bachelor’s degree).
Education: Bachelor’s Degree or equivalent work experience (Two years’ relevant work experience is equivalent to one-year college).
Compensation As of the date of this posting, a good faith estimate of the current pay range is $78,064 to $117,095. The position is eligible for an annual incentive bonus (variable depending on company and employee performance).
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.
Reasonable Accommodations To perform this job successfully, an individual must be able to perform each essential duty satisfactorily. Reasonable accommodations may be made to enable individuals with disabilities to perform the essential functions.
Equal Opportunity Employer We are an Equal Opportunity Employer and do not discriminate against any employee or applicant for employment because of race, color, sex, age, national origin, religion, sexual orientation, gender identity, status as a veteran, and basis of disability or any other federal, state or local protected class.
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