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Regulatory Compliance Audit Analyst Sr Job

Date: Jan 31, 2019

Location: Eagan, Minnesota, US, 55122

Company: Blue Cross and Blue Shield of Minnesota

About Blue Cross



At Blue Cross and Blue Shield of Minnesota, we are developing industry-leading strategies every day that make a healthy difference in people’s lives. Blue Cross has a legacy of improving health through innovation because we believe that everyone should have the opportunity to live the healthiest life possible. Chartered in 1933 as the state’s first health plan, we’ve been serving the health care needs of Minnesotans for more than 80 years.



Blue Cross supports you with competitive pay and a comprehensive benefits package. Many Employee Resource Groups are active in the company, promoting inclusion and helping us meet the diverse needs of our workforce and our members. Join us, and enjoy a work environment where all employees are respected and valued — a workplace honored with a perfect score on the Human Rights Campaign Corporate Equality Index for 2017. Find your place at a company that cares.



 


Description Summary

This position is responsible for planning, directing and coordinating Government Programs external audits. The incumbent will perform compliance risk assessments, gather data, provide analysis, develop processes and documentation, test compliance, and report through the appropriate channels. Responsible for managing Government Programs Compliance cross-functional activities simultaneously to meet regulatory compliance obligations, mitigate risk, and recommend courses of action that align with divisional objectives.


Accountabilities


  1. Plan, direct and manage complex Government Programs Compliance cross-functional projects ensuring they comply with federal and state regulatory requirements and contractual obligations by gathering data, providing analysis, developing processes, assessing vulnerabilities and risks , developing documentation, testing alignment with compliance objectives, and reporting through the appropriate channels.

  2. Leverage organizational knowledge and business acumen and lead through influence to effectively complete projects. Maintain strong business relationships to ensure clear communication of project inputs, needs, deliverables and successes.

  3. Grow and continually update and , while coordinating instruction and team engagement to enable, expand and improve Government Programs Compliance program success.

  4. Develop and implement communication mechanisms that apprise management and leadership of status, including identified risks, advocated remediation and/or escalation.

  5. Oversee effective progress and resolution of any action plan initiated to address vulnerabilities.

  6. Perform other accountabilities as assigned.


Requirements


  • Bachelor’s degree in business or related field and 5 years of related experience, i.e. experience working on or leading projects in the health care industry, with specific compliance program experience or 9 years related experience in lieu of degree.

  • Demonstrated ability to manage complex projects as change agent through engagement of others, development of network resources and partnerships across a matrixed organization.

  • Demonstrated skills in continuous quality improvement and/or project management.

  • Demonstrated problem solving skills, adapting approach as needed.

  • Ability to balance strategic frameworks and deep operational details across a wide range of business areas or topics.

  • Ability to guide, direct and influence teams toward effective accomplishment of objectives. · Demonstrated ability to develop and implement an audit process, analyze findings, communicate results and monitor remediation to timely completion.

  • Serves as an identified subject matter expert with regulatory requirements, including Part C, Part D and state programs.

  • Excellent relationship-building and communication skills, including strong written and presentation communication skills; demonstrated communication experience with diverse audiences and senior leadership.

  • Demonstrated ability to define problems, collect and analyze data, and transform into project-level strategies.

  • Demonstrated ability to work independently and make decisions as needed.


Preferred Requirements


  • Knowledge of team leadership and team member mentorship for success.

  • Significant experience within the health care compliance industry.


FLSA Status

Exempt


Blue Cross Blue Shield of Minnesota is an Equal Opportunity and Affirmative Action employer that values diversity. All qualified applicants will receive consideration for employment without regard to, and will not be discriminated against based on race, color, creed, religion, sex, national origin, genetic information, marital status, status with regard to public assistance, disability, age, veteran status, sexual orientation, gender identity, or any other legally protected characteristic.



Make a difference



Thank you for your interest in Blue Cross. Be part of a company that lets you be you — and make a healthy difference in people’s lives every day



Blue Cross is an Equal Opportunity and Affirmative Action employer that values diversity. All qualified applicants will receive consideration for employment without regard to, and will not be discriminated against based on race, color, creed, religion, sex, national origin, genetic information, marital status, status with regard to public assistance, disability, age, veteran status, sexual orientation, gender identity, or any other legally protected characteristic.



Blue Cross® and Blue Shield® of Minnesota and Blue Plus® are nonprofit independent licensees of the Blue Cross and Blue Shield Association


Nearest Major Market: Minneapolis

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