B

BlueCross BlueShield of South Carolina

Health insurance and plan administration

Lead Contract Compliance Specialist 2

Regulatory Compliance & EthicsPosted on Nov 9
Full-timeColumbia, SC, USANo salary listedHybrid

About the Job

Requirements

  • A Bachelor's degree in a job-related field, or an equivalent of four years of job-related work experience or an Associate's degree and two years of job-related work experience.
  • Seven years of compliance, audit, and/or legal experience.
  • Four years of experience in contract analysis, contracting, and contract preparation; this experience may be concurrent.
  • Ability to act as a liaison with other areas.
  • Ability to analyze information.
  • Ability to conduct audits.
  • Ability to draft contracts.
  • Ability to lead negotiation sessions.
  • Proficiency with Microsoft Office.

Responsibilities

  • Identify filings, reports, and other submissions required for regulatory compliance in all jurisdictions where the company does business.
  • Develop and submit required filings and reports to state insurance regulators on behalf of the company.
  • Manage the identification, collection, and analysis of data and information from internal and external partners to establish compliance with laws and regulations governing market behavior in applicable jurisdictions.
  • Research and interpret statutes, regulations, and agency bulletins to resolve regulatory compliance questions or issues.
  • Review legislative changes and assist in determining their potential impact on business units.
  • Support business divisions in implementing applicable regulatory requirements.
  • Monitor external business partner compliance with company market conduct guidelines and government regulations.
  • Identify necessary improvements and recommend remediation plans to resolve compliance issues.
  • Investigate potential regulatory compliance issues and act as a liaison between the compliance area, other business divisions, and government agencies in connection with such inquiries.
  • Review business division materials and/or plan program materials for compliance and quality, as needed.
  • Research and interpret state and federal laws and regulations to respond to general and product-specific compliance questions.
  • Coordinate with the business to ensure network requirements, standards, and filings comply.
  • Monitor, track, and coordinate privacy and security incidents, including maintaining records and procedures.
  • Draft, file, and maintain products and regulatory reporting to maintain compliance in all jurisdictions where the company does business.
  • Coordinate market conduct and regulatory reporting activities.
  • Issue guidance to business divisions regarding statutory and regulatory developments and assist with technical problems related to implementing laws and regulations.

About the Company

BlueCross BlueShield of South Carolina

Health insurance and plan administration

BlueCross BlueShield of South Carolina is a South Carolina-owned mutual health insurer and health-plan administrator. It offers individual, employer, Medicare and other coverage while operating provider networks, member services, claims and administrative programs. The organization also supports government and commercial health contracts through related businesses and specialized operations. This profile refers specifically to the South Carolina company, not the national Blue Cross Blue Shield Association, and centers on its role connecting members, employers, healthcare providers and public programs.

Company size
Not listed
Company stage
Not listed
Total funding
Not listed
Headquarters
Not listed
Founded
Not listed

Recently Posted Jobs

Explore more opportunities at BlueCross BlueShield of South Carolina

See more jobs