Government Programs Compliance Specialist, Consultant

Your Role

The Promise Medi-Cal Compliance team oversees and coordinates Blue Shield Promise Health Plan's (BSCPHP) compliance program. The Government Programs Compliance Specialist, Consultant will report to the Government Programs Compliance Senior Manager. 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.

Your Knowledge and Experience

• 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