Blue Cross NC · 2 days ago

Compliance Advisor

Remote - North Carolina

Full-time

Remote

Mid Level

$56K/yr - $89K/yr

3+ years exp

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Responsibilities

Utilize knowledge of the compliance and regulatory field to address multifaceted compliance/regulatory questions and problems.

Research, investigate, and evaluate compliance implementation initiatives and required remediation initiatives.

Provide support to business areas by analyzing and recommending effective solutions to compliance issues to best meet business needs.

Ensure overall compliance with new and existing laws, regulations, obligations, Medicare guidance, and/or bid requirements as required by the Compliance Department.

Monitor operational metrics and indicators related to compliance performance and coordinate all activities pertaining to non-financial regulatory audits.

Conduct risk assessments and/or audits and monitor business systems for compliance. Ensure appropriate implementation and/or corrective action is taken to address identified risks and issues.

Analyze and assess environment and compliance program needs. Recommend compliance programming and compliance initiatives to meet those needs.

Develop and implement training and other communications for employees and external entities (e.g., producers and vendors).

Perform reviews of operational policies for compliance and provide feedback to business areas.

May design, develop, and deliver benefit booklets and contracts to meet enterprise-wide project deliverables and initiatives.

May perform compliance reviews of marketing materials for commercial and/or Medicare lines of business.

When working with Medicare products, oversee compliance programs and activities of delegated entities and contractors supporting Medicare programs.

Qualification

Find out how your skills align with this job's requirements. If anything seems off, you can easily click on the tags to select or unselect skills to reflect your actual expertise.

Compliance KnowledgeRisk AssessmentAudit SkillsTraining DevelopmentOperational Policy ReviewBusiness Analysis