Blue Shield of CA
Government Programs Compliance Specialist, Consultant
Blue Shield of CA, El Dorado Hills, California, United States, 95762
Your Role
The Promise Medi-Cal Compliance team oversees and coordinates Blue Shield Promise Health Plan's (BSCPHP) compliance program. The Government Programs Compliance Specialist, Consultant will report to the Government Programs Compliance Senior Manager. In this role you will provide assistance with driving and managing the identification and scoping of impacts across cross-functional business areas due to ongoing, newly enacted, or federal and state regulatory requirements.
Your Knowledge and Experience
Requires a college degree or equivalent experience
Requires a minimum of 7 years of prior relevant experience
Requires extensive experience in the compliance department for a managed care health plan
Extensive and expert knowledge of Knox-Keene Act, California Code of Regulations Titles 22 and 28, and Code of Federal Regulations Title 42 regulatory compliance standards and processes
Strong analytical and investigative skills including risk assessment, mitigation and corrective actions plans
Experience working directly with the California Department of Health Care Services and the California Department of Managed Health Care
Competent in Excel, PowerPoint, and SharePoint
Professional certifications and additional degrees a plus