Compliance Audit Services Specialist, Principal

4 weeks ago


Long Beach, California, United States Blue Shield of California Full time

Your Role

The Promise Compliance Audit Services team oversees all functions of an effective Compliance Program for Blue Shield of California Promise Health Plan. The Compliance Audit Services, Principal will report to the Senior Director, Compliance Audit Services. In this role you will be involved in monitoring and oversight of operational business areas to ensure compliance with contractual and regulatory requirements. You will be responsible for interfacing with other departments regarding the implementation of new or updated regulatory mandates. You will also act as a subject matter expert for regulatory inquiries and support the Compliance Program as needed.

Your Work

In this role, you will:

Be responsible for preparation andsubmissionall standard and nonstandard insurance documents and researching related issues of highly complex nature and recommending solutionsContract management to evaluate adequacy of standard, on-standard, and exception insurance contract requirements & provide recommendationsOversee and develop new processes andprocedureto ensure consistency, accuracy, and efficiency of coordination activities with respect to riskCoordinateroutine and nonroutine processes for insurance application activities between the Company, brokers, and liability insurance carriers to ensure Certificates of Insurance are up-to dateProvide highly complex analysis and define potential loss areas and appropriate type and level of loss protection to be insuredDirects the work of stakeholders or acts as a cross-functional team leadWorks collaboratively in a cross-functional, execution focused environment on large and complex projects of strategic importance to the organizationIndependently prepares clear and concise documentation and leadership reportingLeverages industry best-practice & benchmarking data to drive program maturationOversees the maintenance of existing GRC process documentation, policies, internal controls, training resources, & communications and leads team through the development of new artifacts to support program objectivesYour Knowledge and ExperienceRequires a bachelor's degree or equivalent experienceRequires at least 10 years of prior relevant experienceMust have at least 2 years of prior Medi-Cal mandate implementation experienceCertification in Health Care Compliance preferredRequires strong written and verbal communication skills, relationship building and facilitation skillsRequires strong negotiation skills and ability to successfully interact with all levels of managementPreferred experience planning and leading major initiatives/projectsProficient in Microsoft office (Excel, Outlook, Word, Visio, etc.)Pay Range: The pay range for this role is $136,400.00 to $,204,600.00 for California.

Note: Please note that this range represents the pay range for this and many other positions at Blue Shield that fall into this pay grade. Blue Shield salaries are based on a variety of factors, including the candidate's experience, location (California, Bay area, or outside California), and current employee salaries for similar roles.

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