Compliance Analyst II or III (Depending on Experience)
As a member of the Compliance team, the individual is responsible to deliver an effective compliance program. Designs, implements, delivers, measures and refines activities and controls to prevent, detect and correct violations of state, federal and otherlaws.
Duties may include, but are not limited to, risk assessment, training, monitoring, auditing, external audit coordination, investigation, root cause analysis, regulatory implementation, control assessment, reporting, and corrective actions.
Grade level at hire and upon promotion will be based on such factors as experience, performance, complexity and scope of work assigned, knowledge, and influence skills.
This role may be specific to a product line or area, or may have a broader scope. Special projects may be assigned as needed.
Responsibilities & Requirements
- Proven ability to deliver effective Core Compliance activities, including, monitoring, auditing, root cause analyses, and corrective actions.
- Skilled in project management and delivery including proven ability to initiate and manage multiple projects and priorities.
- Excellent written and oral communication and presentation skills
- Excellent research and analytics skills, with proven ability to distill actionable, practical advice from diverse sources and opinions. Legal research skills preferred.
- Proven ability to influence effectively at all levels of the organization.
- Excellent independent judgment and decision-making skills.
- PC literate with office computer software – Word, Excel, PowerPoint, Outlook, Visio, etc.
- Discretion and confidentiality.
- Agile, with high learning velocity.
Normally to be proficient in the competencies listed above:
Compliance Specialist II would have a Bachelor’s degree or equivalent experience; 5years of compliance experience or equivalent related experience, with experience in a health care or Medicare-regulated environment preferred; and would also have:
- Demonstrated fluency in organizational agility: knowledgeable how about organizations work and how to get things done through formal and informal channels;
- Practical familiarity with legal requirements relating to assigned compliance program, or for new hires, practical familiarity with analogous legal requirements;
- Demonstrated mastery of at least four Compliance functions , to include the core competencies: risk assessments, training, policies and procedures, monitoring, auditing, external audit coordination, control assessments, reporting, corrective actions, implementation oversight, and ability to perform those compliance functions effectively within that compliance program; or if assigned to a specialized function (e.g. FDR/ DDE Compliance, Marketing Materials Review, Data Validations), mastery of all competencies related to that specialized function
- Demonstrated ability to handle successfully at least medium-complexity, medium-difficulty matters end-to-end; and
- Demonstrated ability to drive success with challenging partners.
General Functions and Outcomes
- Overall responsibilities include specific and/or portions of the following functions that relate to an effective compliance program utilizing as a basis the seven elements of compliance.
- Duties include aspects of the preparation, planning, coordination, project management, submission, administration, monitoring and auditing of the Cambia compliance program which serves to oversee activities related to requirements, laws and regulations to prevent, detect and remediate compliance issues of the company.
- Responsibility for producing and maintaining policies and desk manuals for position;
- Works as a team with other staff members assigned in either a supporting or leading role;
- Participating in the annual risk assessment process;
- Ensuring materials, reports, and other documents are written in an understandable and and concise style;
- Project management and implementation;
- Participating, supporting and serving in regular meetings, including divisional and cross-divisional committees as needed.
- Core Competencies: risk assessments, training, policies and procedures, training, monitoring, auditing, root cause analysis, and corrective actions
- Additional Competencies: external audit coordination, implementations, control assessments, delegation oversight, data validation, marketing material oversight, DDE/FDR oversight
- Work primarily performed in office environment; some remote work may be acceptable.
- Travel rarely required, locally or out of state.
- May be required to work outside normal hours
At Cambia, we advocate for transforming the health care system. You aren’t satisfied with the status quo and neither are we. We're looking for individuals who are as passionate as we are about transforming the way people experience health care. We offer a competitive salary and a generous benefits package. We are an equal opportunity employer dedicated to workforcediversity and a drug and tobacco-free workplace. All qualified applicants will receive consideration for employment without regard to race, color, national origin, religion, age, sex, sexual orientation, gender identity, disability, protected veteran status or any other status protected by law. A drug screen and background check is required.
Cambia’s portfolio of companies spans health care information technology and software development; retail health care; health insurance plans that carry the Blue Cross and Blue Shield brands; pharmacy benefit management; life, disability, dental, vision and other lines of protection; alternative solutions to health care access; and free-standing health and wellness solutions.
We have over a century of experience in developing and providing health solutions to serve our members. We had our beginnings in the logging communities of the Pacific Northwest as innovators in helping workers afford health care. That pioneering spirit has kept us at the forefront as we build new avenues to improve access to and quality of health care for the future.
Requisition ID 2017-23942