Commercial Compliance Specialist II

Blue Cross of Idaho is seeking a Commercial Compliance Specialist to analyze and distribute new and updated regulatory requirements to pertinent business areas. The role is also involved in advising business areas of their compliance obligations and to support and coordinate audits of Blue Cross of Idaho's commercial products. The specialist will also be involved in helping to resolve compliance issues that emerge in our commercial products.

We're seeking for a Specialist with:

Experience: 4 years' health industry, internal audit, legal, compliance, or government programs (12 years of experience if candidate does not have Bachelor's degree)

Education: Bachelor's Degree or equivalent work experience (Two years' relevant work experience is equivalent to one-year college)

Your day may look like:

• Maintains and applies knowledge of regulations and regulatory changes relevant to the industry and the organization - CMS, Department of Labor, Department of Insurance, and others

• Supports and/or coordinates external audits of BCI undertaken by external government regulators.

• Acts as a subject matter expert for regulatory requirements pertaining to BCI commercial products.

• Ensures regulatory standards are applied to organizational policies and procedures by evaluating and communicating regulatory guidance to impacted business areas.

• Performs periodic risk assessments on operational areas with regulatory lines of business and contributes to monitoring and auditing workplans.

• Responds to compliance and privacy related questions, complaints, and incidences. Investigates and risk-ranks reported compliance issues. Works with business and process owners to develop corrective action plans that effectively remediate issues and prevent future occurrences.

• Facilitates or supports organizational compliance training on general compliance and other topics required by regulation.

• Conducts monitoring, auditing and surveillance of operational functions, reports results to business process owners, and takes compliance actions in response to findings. Analyzes monitoring and surveillance results that are reported to compliance by business areas.

• Works with business relationship owners and vendors to train, educate, mitigate compliance risks, and drive industry best practices.

• Performs other duties and responsibilities as assigned.

Reasonable accommodations

To perform this job successfully, an individual must be able to perform each essential duty satisfactorily. The requirements listed above are representative of the knowledge, skill and/or ability required. Reasonable accommodations may be made to enable individuals with disabilities to perform the essential functions.

We are an Equal Opportunity Employer and do not discriminate against any employee or applicant for employment because of race, color, sex, age, national origin, religion, sexual orientation, gender identity, status as a veteran, and basis of disability or any other federal, state or local protected class.