Compliance Business Unit Specialist

<p><strong>With more than 8,000 employees, we are the largest health insurance company in Michigan. We offer an exciting work environment with a diverse group of employees. Our goal is to make health insurance easier for our members. We want to transform the industry and become a resource that people can trust. Interested in joining us?</strong></p>

Detroit, MI

Blue Cross Blue Shield of MI

Our Mission: We commit to being our members&rsquo; trusted partner by providing affordable, innovative products that improve their care and health. Our Customer Commitment: We aspire to be clear and simple, to help you make the right choices, to offer valuable coverage, and help you get quality health care for you and those you love. Our Commitment to our Social Mission: Increasing access to affordable health care Enhancing the quality of care patients receive Improving the health of Michigan&rsquo;s citizens and communities. <br /> <p><br />Our employees are eligible for several great perks:</p> <ul> <li>Comprehensive medical, dental and vision insurance</li> <li>401(k) with company match</li> <li>Annual bonuses</li> <li>Tuition assistance</li> <li>Paid parking</li> </ul>

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Competitive Total Compensation Package

Overview: <p>This position is responsible for supporting the BCBSM and BCN Corporate Compliance Offices by directing and assisting leaders in the implementation, monitoring and maintenance of legal and regulatory requirements throughout the enterprise, (e.g. HIPAA Privacy and Security requirements, Medicare Advantage and Prescription Drug, requirements in accordance with CMS).&nbsp; Provides guidance to corporate leaders and individual employees that identify compliance issues and recommend corrective action plans enterprise-wide.&nbsp; Consults with business areas and other subject matter experts to identify compliance requirements, assess risks, and recommend compliant solutions that support business goals. &nbsp;&nbsp;This position acts as subject matter expert on applicable regulations (e.g. HIPAA, Medicare, etc.), training and awareness programs, and for responding to compliance-related inquiries.</p>
Responsibilities: <ul> <li>Develop, implement and administer compliance monitoring programs, risk assessment and compliance processes.&nbsp;</li> <li>Provide analysis, process flows, written reports and documentation. &nbsp;</li> <li>Represent director and manager on committees and at meetings.&nbsp;</li> <li>Perform and lead compliance reviews and enterprise-wide compliance evaluations on an on-going basis.&nbsp;</li> <li>Supervise Corporate Compliance senior analysts on assigned tasks, project risk assessments and manage relationships to help ensure efficient and effective solutions are implemented. Coordinate with business areas (e.g. Federal Programs Business Unit, Information Services Security, Enterprise Security, etc.) to develop and update content for new and on-going training and awareness programs.</li> <li>Develop detailed plans to address complex compliance issues by identifying goals, objectives and risks to achieving compliance objectives. &nbsp;</li> <li>Coordinate with business areas to implement corrective action plans when needed. Investigate compliance and control issues to resolve complex problems and make recommendations to business leaders and employees to ensure on-going compliance.&nbsp;</li> <li>Review and interpret new and existing regulations (e.g. HIPAA Privacy and Security, Medicare Parts C and D), and&nbsp;&nbsp;coordinate with legal staff to provide opinions on compliance issues.&nbsp; Maintain knowledge of regulations impacting the&nbsp;company and industry.&nbsp;</li> <li>Assist leaders with implementation of requirements and validate compliance requirements during on-going reviews.&nbsp;</li> <li>Develop compliance communications (e.g. web site, content, Compliance Corner articles, presentations etc.) for various&nbsp;audiences as needed.</li> </ul>
Requirements: <ul> <li>Bachelor's Degree in related field required.</li> <li>Master's Degree in Business Administration, additional related certifications preferred.</li> <li>Five (5) to seven (7) years in related health care field which may include experience in technical/systems, information security, compliance and/or audit and risk assessments.</li> <li>Leadership/supervisory experience preferred. Ability to develop and present complex materials in a clear, concise and persuasive manner.</li> <li>Working knowledge of HIPAA legislation, privacy rules, or security standards, or federal regulations related to Medicare Parts C and D, or advanced knowledge of risk assessment concepts and generally accepted auditing principles.</li> <li>Ability to plan, organize, direct and control projects while exercising high ethical standards and good judgment.</li> <li>Excellent analytical, organizational, interpersonal, problem solving, written and verbal communication skills, as well asthe ability to apply concepts to practical situations.</li> <li>Ability to work independently with minimal supervision, within a team environment and handle multiple assignments.</li> <li>Working knowledge of PC applications (Word, Excel, PowerPoint and Outlook).Other related skills and/or abilities may be required to perform this job.</li> <li>Position requires 25% of travel</li> </ul> <p><em>All qualified applicants will receive consideration for employment without regard to, among other grounds, race, color, religion, sex, national origin, sexual orientation, age, gender identity, protected veteran status or status as an individual with a disability.</em></p>