Job Description

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. The Compliance and Ethics, Consultant is a critical individual contributor and leader 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 highly preferred. Requires a minimum of 7 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). Experience driving, leading, managing, implementing, and maintaining corporate compliance and ethics program projects from hotline implementation to compliance program assessments and communication and training programs. 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. #J-18808-Ljbffr Blue Shield of CA

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