Posted in General Business 30+ days ago.
Type: Full-Time
Our organization is looking for dynamic individuals who love to learn, thrive on innovation, and are open to exploring new ways to achieve our goals. If this describes you, we want to speak with you. You can help us achieve our vision to lead nationally in innovating equitable whole-person health.
The Regulatory Performance Analyst III serves as Subject Matter Expert (SME) and compliance consultant for assigned business areas. Responsible for maintaining productive relationships with leaders in business areas falling under their SME purview. Anticipating compliance needs, communicating regulatory requirements to operational areas and conducting follow up to assure implementation. Analyzes and clarifies regulatory, sub regulatory guidance as required, for business areas and obtains clarification of guidance as appropriate. Stays continuously up to date with best practices across the industry, especially other Blues, seeks opportunities to enhance compliance and keeps business areas up to date. Identifies possible compliance issues, assists with investigation and resolution, escalating issues when appropriate. Conducts monitoring to measure compliance with Federal and State regulations and guidance, communicates findings to impacted business areas and completes follow up to assure resolution of the identified issues.
Responsibilities:
Qualifications
· Bachelor’s degree in related field or equivalent work experience.
· Minimum of 5 years related work experience in managed care or health care compliance.
· Excellent critical thinking, organization, verbal and written communication skills required.
· Working knowledge of Microsoft Office products required.
· Knowledge of Federal and/or State regulations related to the health insurance industry is an asset.
Independence has implemented a “Hybrid” model which consists of Associates working in the office 3 days a week (Tuesday, Wednesday & Thursday) and remotely 2 days a week (Monday & Friday). This role is designated as a role that fits into the “Hybrid” model. While associates may work remotely on our designated remote days, the work must be performed in the Tri-State Area of Delaware, New Jersey or Pennsylvania.
Must have an Android or iOS device which is compatible with the free Microsoft Authenticator app.
Independence Blue Cross is an Equal Opportunity and Affirmative Action Employer. All qualified applicants will receive consideration for employment without regard to their age, race, color, religion, sex, national origin, sexual orientation, protected veteran status, or disability.
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