Compliance Advisor

<p>With more than 7,000 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.</p>

Detroit, MI

Blue Cross Blue Shield of Michigan

When you think of <a href="https://www.bcbsm.com/" target="_blank" rel="noopener noreferrer">Blue Cross Blue Shield of Michigan</a> for health insurance, you can know you&rsquo;re getting much more. We're a company founded on a tradition of affordable, quality health care for everyone, improving the present and investing in the future.<br /><br />We offer:<br />Plans for employers and individuals that meet today&rsquo;s needs, budgets and lifestyle<br />The largest network of doctors and hospitals in the state<br />Lower health care costs Higher quality health care<br />Award-winning diversity practices<br />Grants and programs that promote better health throughout Michigan<br /><strong><br />Mission:&nbsp;</strong>We commit to being our members&rsquo; trusted partner by providing affordable, innovative products that improve their care and health.<br /><br /><a href="http://www.bcbsm.com/index/about-us/our-company.html" target="_blank" rel="noopener noreferrer"><strong>Click here</strong></a> to learn more about our commitment to our Social Mission, view company updates and reviews, and view our awards &amp; accolades.<br /><br />Learn more about your options as an external candidate. <a href="https://bcbsm.taleo.net/careersection/2/jobsearch.ftl?lang=en" target="_blank" rel="noopener noreferrer">Click here</a> to view open positions.&nbsp; http://www.bcbsm.com

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Full-time

Competitive Total Compensation Package

Overview: Support compliance efforts through, monitoring and maintenance of legal and regulatory requirements (i.e. HIPAA privacy and security, Medicare Advantage, prescription drug and CMS requirements). Coordinate communications and provide training/support to business units. Provide guidance to business units and serve as a subject matter expert regarding healthcare regulations.
Responsibilities: <ul> <li>Provides leadership, mentors, trains and oversees work of Compliance Analysts, Senior Compliance Analysts, and Corporate Compliance Specialists.</li> <li>Leads the development of and the execution of the Company&rsquo;s overall vendor regulatory compliance.</li> <li>Leads preparation for regulatory audit activity and compliance training programs.</li> <li>Partners with, and influences as necessary, subject matter experts and information providers.</li> <li>Build and maintain customer relationships to establish credibility, understands each customers current and future business needs and influences without positional authority.</li> <li>Manage and collaborate with various workgroup participants to ensure teams are on track, and understand the interpretation of the law; resolve or escalate issues. Partner with business leads to co-direct initiatives as needed.</li> <li>Exercise discretion and independent judgment to resolve problems such as vendor and internal compliance issues,</li> <li>Prepare progress summaries for executive management including the Board of Directors Audit Committee.</li> </ul> <p><strong>Department Job Summary</strong>:<br />Maintains key enterprise policies (Health Information Privacy Policy and Privacy Incident Response Management policy) and public facing privacy information (Notice of Privacy Practices). The area also manages privacy incident triage, investigation and reporting, oversees privacy training and education programs, and guides the business through privacy issue oversight.</p>
Requirements: <ul> <li>Bachelor's Degree in business administration, economics, healthcare or related field is required. Master&rsquo;s Degree in related field preferred.</li> <li>Five (5) years&rsquo; experience in related healthcare field, Medicare Advantage preferred, which may include experience in technical/systems, information security, compliance and/or audit and risk assessments.</li> <li>Prior supervisory experience preferred.</li> <li>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>Excellent analytical, organizational, interpersonal, problem solving, written and verbal communication skills, as well and the ability to apply concepts to practical situations.</li> <li>Experience in conflict management skills necessary to resolve issues.</li> <li>Advanced written and oral communication skills.</li> <li>Advanced proficiency with Microsoft Office suite.</li> <li>Basic knowledge of project management (PMP not required, but helpful).</li> <li>Ability to effectively interface with various levels of management internally and as well as contacts outside the organization.</li> <li>Ability to work effectively under minimal direction in a team environment.</li> <li>At least 25% domestic travel, including overnight, expected.</li> </ul> <p><strong>Department Preferences:</strong>&nbsp;<br />Knowledge of BCBSM health insurance environment as well as expertise with privacy legislation, such as HIPAA and HITECH. Prior experience developing company training, including scripts, desired.</p> <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>