Senior Compliance Analyst

Summary Researches, resolves, and tracks suspected compliance/privacy issues and provides guidance to management and employees. Conducts complex internal/external compliance audits. Provides information on compliance activities for reports to board of directors, executive management, and other internal and external sources as needed. Description • Conducts ongoing, internal and external, compliance reviews and audits ensuring compliance with applicable contract provisions and government regulations, and identifies all necessary improvements. Investigates and resolves compliance issues from a legislative/regulatory standpoint. Provides guidance to management and employees as needed, • Researches and analyzes federal and state regulations and guidance to determine impact to business. Initiates and monitors Corrective Action Plans necessary to accomplish and sustain compliance. Leads projects related to developing or enhancing compliance tools used to monitor operating practices or gaps in procedures. • Leads initiatives to educate business units on compliance programs. Provides guidance to less experienced compliance staff. • 10% Generates and submits data and reporting on compliance activities as needed for government and regulatory agencies. Interacts with regulatory officials as necessary. • Reviews compliance department materials and/or health plan program materials for compliance and quality. This may include member materials, marketing documents, and training curricula. Required Education: Bachelor's Degree Required Work Experience: Six years health insurance, compliance or audit, investigations, or corporate level related experience. Required Skills and Abilities: Ability to effectively communicate verbally and in writing to all levels of the organization. Excellent analytical or critical thinking and problem solving capabilities. Ability to make sound decisions and work independently. Ability to exercise confidentiality and discretion. Strong attention to detail. Demonstrated knowledge of government laws and regulations impacting the insurance industry. Extensive knowledge of compliance practices and procedures. Current knowledge of changes in applicable regulations. Required Software and Tools: Microsoft Office. Preferred Education: Bachelor's degree in Business Administration or other job related field of study. Preferred Work Experience: Medicare or government healthcare program experience. Preferred Licenses and Certificates: Compliance Certification such as HCP or CCEP a plus. Work Environment: Typical office environment. Some travel may be required. We participate in E-Verify and comply with the Pay Transparency Nondiscrimination Provision. We are an Equal Opportunity Employer. Equal Employment Opportunity Statement BlueCross BlueShield of South Carolina and our subsidiary companies maintain a continuing policy of nondiscrimination in employment to promote employment opportunities for persons regardless of age, race, color, national origin, sex, religion, veteran status, disability, weight, sexual orientation, gender identity, genetic information or any other legally protected status. Additionally, as a federal contractor, the company maintains Affirmative Action programs to promote employment opportunities for minorities, females, disabled individuals and veterans. It is our policy to provide equal opportunities in all phases of the employment process and to comply with applicable federal, state and local laws and regulations. We are committed to working with and providing reasonable accommodations to individuals with physical and mental disabilities. If you need special assistance or an accommodation while seeking employment, please e-mail abilities@bcbssc.com or call 1-800-288-2227, ext. 43172 with the nature of your request. We will make a determination regarding your request for reasonable accommodation on a case-by-case basis.