Job Description

Awarded the Best Place to Work 2021, Blue Cross Blue Shield of Arizona helps to fulfill its mission of improving the quality of life of Arizonans by delivering a variety of health insurance products and services to meet the diverse needs of individuals, families, and small and large businesses as well as providing information and tools to help individuals make better health decisions.

Internal Use Only: GEN 29-30

PURPOSE OF THE JOB

Performs ethics, government compliance, corporate compliance, or privacy investigation, research, and training to ensure that BCBSAZ complies with state and federal laws, as well as activities that promote an ethics culture within BCBSAZ.

QUALIFICATIONS

REQUIRED QUALIFICATIONS

1. Required Work Experience

· 6 months of experience with government or corporate compliance, privacy, or legal issues (Level 1)

· 4 years of experience with government or compliance, privacy, or legal issues (Level 2)

· 5 years of experience with government or compliance, privacy, or legal issues (Level 3)

2. Required Education

· High School Diploma or equivalent. (All Levels)

3. Required Licenses

· N/A

4. Required Certifications

· N/A

PREFERRED QUALIFICATIONS

1. Preferred Work Experience

· 3 years’ experience with compliance, privacy, government programs or legal issues in a healthcare industry (Level 1)

· 5 years’ experience with compliance, privacy, government programs or legal issues in a healthcare industry (Level 2)

· 7 years’ experience with compliance, privacy, government programs or legal issues in a healthcare industry (Level 3)

2. Preferred Education

· Bachelor’s degree in business or related field of study (Levels 1 and 2)

· Master’s Degree in business or healthcare field of study. (Level 3)

3. Preferred Licenses

· N/A

4. Preferred Certifications · Specialized training and/or certification from the BCBS Association (Levels 1 and 2) · Advanced compliance professional or legal training (Level 3)

ESSENTIAL JOB FUNCTIONS AND RESPONSIBILITIES

LEVEL 1

* Researches, writes, and conducts reviews of policies and procedures to ensure compliance, accuracy, and alignment with

current business practices,

* Process improvement initiatives of current procedures, reporting and system usage ensuring accuracy, efficiency, and

timeliness of policy submissions,

* Researches, writes and delivers new compliance, privacy and ethics training modules for both on-line and stand-up

delivery that applies the laws, regulations and policies to targeted risk areas (i.e. anti-trust issues for Sales staff).

* Researches, develops, and writes employee supplemental education materials such as brochures, flyers, e-mail notices,

newsletter articles and website content on complex ethical, government or corporate compliance, or privacy issues.

* Implements the annual Code of Conduct distribution and Conflict of Interest Disclosure Questionnaire process or similar

attestations and certifications to employees, officers and Board of Directors and vendors as appropriate. Analyzes

responses requiring further action.

* Participates on corporate teams as necessary.

* Research best practices and new government laws and regulations for government and corporate compliance, privacy,

ethics programs and recommends modifications to programs based on BCBSAZ’s size, corporate culture and risk

assessments.

* Develops, implements, and performs monitoring and auditing systems as reflected in the Federal Sentencing Guidelines

and government program guidance for compliance and privacy including those required for regulatory agencies,

Company management and Board of Directors.

LEVEL 2

* Performs delegation audits in accordance with accreditation, privacy and regulatory standards.

* Provides consultation to management on compliance and privacy issues that affect their departments.

* Represents BCBSAZ at industry conferences and presents best practices.

* Manages projects with multi-disciplinary teams.

* Works collaboratively and cross trains with other Compliance Administrators.

* Acquires and maintains an in-depth knowledge of legal requirements, current government or corporate compliance and

ethics, industry practices. Serves as subject matter expert.

LEVEL 3

* Through critical analysis, identifies possible violations of laws, regulations, policies or fraudulent activities of employees,

providers, subscribers, vendors and contractors by applying the appropriate legal, corporate or ethical policy.

* Performs in-depth investigations for possible violations or fraudulent activity by researching, data gathering, interviewing,

analyzing findings, developing corrective action plans and implementing those plans. Prioritizes and prepares cases for

regulatory agency oversight. Some field work is required.

* Assist team in meeting project deadlines and schedules.

* Mentors team members and trains new team members

* Assists management of Corporate Integrity as required on other projects / tasks. * Assigns, tracks and oversees government compliance work. (Compliance - Government Lead) ALL LEVELS * Each progressive level includes the ability to perform the essential functions of any lower levels. * The position requires a full-time work schedule. Full-time is defined as working at least 40 hours per week, plus any additional hours as requested or as needed to meet business requirements. * Performs all other duties as assigned.

COMPETENCIES

REQUIRED COMPETENCIES

1. Required Job Skills (All Levels)

· Intermediate skill in use of office equipment, including copiers, fax machines, scanner and telephones

· Intermediate PC proficiency

* Intermediate proficiency in spreadsheet, database, presentation and word processing software

2. Required Professional Competencies (All Levels)

· Advanced knowledge of ethical, corporate or government compliance, or HIPAA Privacy issues

· Analytical skills to support independent and effective decisions

· Prioritize tasks and work with multiple priorities, sometimes under limited time constraints.

· Perseverance in the face of resistance or setbacks.

· Effective interpersonal skills and ability to maintain positive working relationship with others.

· Verbal and written communication skills and the ability to interact professionally with a diverse group, executives,

managers, and subject matter experts.

· Ability to create and deliver employee education of complex government or corporate compliance, privacy and

ethical issues in an understandable way.

· Maintain confidentiality and privacy

· Analytical knowledge necessary to generate reports based on available data and then make decisions based on

reported data

3. Required Leadership Experience and Competencies (All Levels)

· Take appropriate risks using available data

* Build synergy with a diverse team in an ever-changing environment.

PREFERRED COMPETENCIES

1. Preferred Job Skills (All Levels)

· Advanced skill in use of office equipment, including copiers, fax machines, scanner and telephones

· Advanced PC proficiency

· Advanced proficiency in spreadsheet, database, presentation and word processing software

2. Preferred Professional Competencies (All Levels)

· Expert knowledge of ethical, government or corporate compliance, or HIPAA Privacy

· Ability to work with ambiguous and conflicting information while keeping focused on the end goal.

3. Preferred Leadership Experience and Competencies

* N/A

Our Commitment

BCBSAZ does not discriminate in hiring or employment on the basis of race, ethnicity, color, religion, sex, sexual orientation, gender identity, national origin, age, disability, protected veteran status or any other protected group.

Thank you for your interest in Blue Cross Blue Shield of Arizona.  For more information on our company, see azblue.com.  If interested in this position, please apply.

Application Instructions

Please click on the link below to apply for this position. A new window will open and direct you to apply at our corporate careers page. We look forward to hearing from you!

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