Blue Shield of CA
Compliance and Ethics Program Specialist, Senior
Blue Shield of CA, Redding, California, United States, 96001
Your Role
The Compliance and Ethics team ensures adherence to the BSC Code of Conduct and owns and coordinates the Company's compliance and ethics program across the enterprise, including all business units, products, services and activities. This includes the implementation and maintenance of proper preventive, detective and remedial programs and controls; the execution of relevant policies and procedures; training and educating the workforce; implementing an effective communications program; ensuring effective testing, auditing, monitoring, tracking and reporting; and remediate control deficiencies.
This Senior Level Compliance and Ethics Specialist is a critical individual contributor and program lead who will report to the Senior Manager, Compliance and Ethics. In this role you will work closely with the Senior Manager and department to drive and lead the department's strategic priorities and projects, including advancing the compliance training program, developing and implementing compliance policies such as the Conflict of Interest, Gifts and Entertainment, Anti-Corruption, etc., and serve as a subject matter expert on compliance issues, providing guidance and support to various departments within the organization. Our leadership model is about developing great leaders at all levels and creating opportunities for our people to grow - personally, professionally, and financially. We are looking for leaders that are energized by creative and critical thinking, building and sustaining high-performing teams, getting results the right way, and fostering continuous learning.
Your Knowledge and Experience
Requires a Bachelor's degree; Masters in relevant field or Juris Doctor preferred
Requires a minimum of 5 years of prior relevant experience (experience in a health plan or related health care organization preferred)
Requires Certification in Healthcare Compliance (CHC) or Certified Ethics and Compliance Professional (CCEP)
Exceptional written and verbal communication skills, including the ability to explain complex regulatory requirements to diverse audiences
Experience with project management preferred. Excellent execution skills required
Working knowledge of healthcare regulations and compliance requirements, including the DOJ Federal Sentencing Guidelines, OIG Compliance Plan, Privacy Rules, Stark Law, Anti-kickback statute, and Fraud and Abuse
Experience collecting and analyzing data and developing sophisticated reports on compliance and ethics data and metrics
Advanced presentation skills, including PowerPoint, Excel, Word
Experience and success in program/project management and driving change
Key necessary competencies include critical thinking, business acumen, collaboration, ability to influence others, strong written and verbal communication, efficient time management, and excellent organizational & problem-solving skills