Operations Compliance Specialist I at Blue Cross of Idaho

Blue Cross of Idaho is seeking an Operations Compliance Specialist to be a part of our Operational Performance & Implementation team. This role will ensure our compliance with governmental laws and regulations for Government lines of business and/or operations area of the organization.

We're seeking a Specialist with

Experience: 2 years’ health industry, internal audit, legal, compliance, or government programs experience

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

Your Day May Look Like

• Maintain and apply knowledge of business rules and regulations/regulatory changes relevant to the industry and to the organization.
• Development of internal documentation including policies, procedures, and Business Rule Documentation.
• Manage the collection and submission of all regulatory required reports and information requests.
• Work directly with regulatory contract monitors to address member, provider, and ad hoc inquiries.
• Monitor areas of risk and call out concerns to leadership and/or the compliance department.
• Coordinate, direct, and monitor activities across regulatory lines of business.
• Identify, facilitate, and develop specialized training needs specific to regulatory lines of business.
• May develop audits to identify and assess areas of compliance and privacy risk.
• May review complaints for regulatory compliance. May determine root cause and issue corrective actionable recommendations to leadership.
• Performs other duties and responsibilities as assigned.
  
  

As of the date of this posting, a good faith estimate of the current pay range is $25.55 to $35.77. The position is eligible for an annual incentive bonus (variable depending on company and employee performance).

The pay range for this position takes into account a wide range of factors including, but not limited to, specific competencies, relevant education, qualifications, certifications, relevant experience, skills, seniority, performance, travel requirements, internal equity, business or organizational needs, and alignment with market data. At Blue Cross of Idaho, it is not typical for an individual to be hired at or near the top range for the position. Compensation decisions are dependent on factors and circumstances at the time of offer.

We offer a robust package of benefits including paid time off, paid holidays, community service and self-care days, medical/dental/vision/pharmacy insurance, 401(k) matching and non-contributory plan, life insurance, short and long term disability, education reimbursement, employee assistance plan (EAP), adoption assistance program and paid family leave program.

We will adhere to all relevant state and local laws concerning employee leave benefits, in line with our plans and policies.

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.