Sr Consultant Ethics and Compliance

The hiring range for this role is:  

92,086.00 - 129,145.00

This is the lowest to highest salary we, in good faith, believe we would pay for this role at the time of this posting.  We may ultimately pay more or less than the hiring range andthis hiringrange may also be modified in the future. A candidate’s position within the hiring range may be based on several factors including, but not limited to, specific competencies, relevant education, qualifications, certifications, relevant experience, skills, seniority, performance, shift, travel requirements, and business or organizational needs. This job is also eligible for annual bonusincentivepay.

We offer a comprehensive package of benefits including paid time off, 11 holidays, medical/dental/vision insurance, generous 401(k) matching, lifestyle spending account and many other benefits to eligible employees.

Note: No amount of pay is considered to be wages or compensation until such amount is earned, vested, and determinable. The amount and availability of any bonus, commission, or any other form of compensation that are allocable to a particular employee remains in the Company's sole discretion unless and until paid and may be modified at the Company’s sole discretion, consistent with the law.

Serves as the primary internal resource to the Ethics and Compliance Official on compliance matters, and as an information resource to BCBS Plans and other external and internal stakeholders. Leads internal/external compliance-related training programs, including required ethics training and conflict of interest process. Leads Plan compliance activities including monthly calls, roundtables, national teleconferences, and annual conferences. Establishes and maintains productive relationships with both internal and Plan senior staff to build consensus and provide solutions and training support for emerging compliance issues. Facilitates the sharing of best practices between the Plans and business partners on compliance activities.

Primary Job Functions

• Serves as the Ethics and Compliance Official’s primary support for the BCBSA Ethics & Compliance Program. Leads internal and external compliance requirements, including new hire ethics training, annual ethics refresher training, new-hire conflict of interest process, annual conflicts of interest process, and the annual ethics awareness event.
• Leads the coordination and hosting of Compliance & Ethics educational programming for Blue Plan compliance and ethics professionals, including all monthly/bi-monthly Blue Plan Compliance & Ethics calls. Leads the planning and coordinating of the Compliance and Ethics track at the Annual BCBSA Law, Audit, Compliance & Ethics Conference, including topical roundtables and mini-conferences. Researches and stays current on important industry issues, develops program agendas and attendee communications, procures speakers, coordinates vendors, and supervises the administration of these events. Secures Continuing Education credits for industry certifications for all events.
• Serves as the primary resource for Plan Compliance and Ethics professionals at the Association. Takes the lead on collaborating with Plans in a customer/client relations capacity, fielding requests for information, locating subject matter experts, and using business judgment to assist with answering questions. Partners with BCBSA business and policy teams to develop programs and explore opportunities. Identifies Compliance and Ethics related vendor/purchasing opportunities and acts as liaison between Plans and BCBSA’s contracting staff for national purchasing contracts. Analyzes confidential data to create value-added resources for Plans. Conducts and disseminates the Bi-Annual Plan Compliance Survey for Blue Plan leadership. Conducts the annual Multi-Plan Ethics Survey for Blue Plans.
• Responsible for daily monitoring of the BCBSA Compliance Officer and Ethics shared mailboxes and responding as appropriate to requests. Monitors Compliance Line and assists in compliance investigations.
• Manages and organizes databases, education resources, and Compliance and Ethics listservs. Maintains an active calendar of C&E events. Maintains an active database of Plan Compliance and Ethics departments. Maintains the Compliance and Ethics resource and document repository on PlanConnexion. Coordinates all key department electronic services.

Education, Experience, and Certification

Education:

Required: Bachelors degree in Business, Project Management, Compliance, or Ethics

Experience:

Required: a minimum of five (5) years of relevant compliance and ethics experience, preferably in a healthcare or managed care environment.

Required: a minimum of three (3) years' experience in the interpretation and application of federal and state regulations, policies and procedures, and ethical principles related to healthcare compliance.

Preferred:

Experience with BCBS systems/applications.

Experience with Liferay and other web publishing tools.

Certification:

Required:

• Certified Compliance & Ethics Professional Certification (CCEP) - Compliance Certification Board
• Certified in Healthcare Compliance (CHC) - Compliance Certification Board
• Leadership Professional in Ethics & Compliance (LPEC) - Ethics and Compliance Institute

Knowledge, Skills, and Abilities

• Requires high degree of discretion in helping to manage sensitive compliance/ethics activities.
• Strong understanding of best practices in internal ethics and compliance programs.
• Strong organization and prioritization skills. Adept at managing a high volume of work with changing priorities.
• Critical thinking skills and the ability to apply an analytical approach to research and issue remediation.
• Persuasion/negotiation and interpersonal relationship skills and the ability to effectively interact and collaborate with individuals at all levels within the organization.
• High-level problem-solving acumen. Ability to identify potential noncompliance issues, obtain information to clarify and describe issue, exercise sound decision-making, resolve problems using appropriate risk treatment, and leverage appropriate escalation pathways.
• Strong knowledge of MS Office platform including the ability to effectively utilize PowerPoint and Word to prepare presentations and reports.

Revenue Responsibility: No

Budget Responsibility: No

People Management: No

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