Job Details

Overview

The Promise Medi-Cal Compliance team oversees and coordinates Blue Shield Promise Health Plan's (BSCPHP) compliance program. The Government Programs Compliance Analyst, Consultant will report to the Senior Director, Government Programs Compliance. In this role you will provide assistance with driving and managing the identification and scoping of impacts across cross-functional business areas due to ongoing, newly enacted, or federal and state regulatory requirements.

Qualifications

• Requires a college degree or equivalent experience
• Requires a minimum of 7 years of prior relevant experience
• Requires extensive experience in the compliance department for a managed care health plan
• Extensive and expert knowledge of Knox-Keene Act, California Code of Regulations Titles 22 and 28, and Code of Federal Regulations Title 42 regulatory compliance standards and processes
• Strong analytical and investigative skills including risk assessment, mitigation and corrective actions plans
• Experience working directly with the California Department of Health Care Services and the California Department of Managed Health Care
• Competent in Excel, PowerPoint, and SharePoint
• Professional certifications and additional degrees a plus