Manager, Private Business Compliance (Columbia)

Compliance Manager

The Compliance Manager handles day-to-day regulatory compliance issues. Researches, resolves, and tracks suspected compliance issues. This role provides guidance to management and employees on compliance issues as well as negotiates privacy agreements and performs various internal audits.

What You'll Do

• Assists in developing, implementing, and monitoring compliance plans for one or more of the following; Medicaid, Health Insurance Portability and Accountability Act (HIPAA) privacy, National Committee for Quality Assurance (NCQA) confidentiality requirements, and branding requirements. Develops and performs internal compliance audits and investigates compliance issues. Ensures all reports filed to regulatory agencies are correctly completed and filed in a timely manner.
• Maintains current knowledge of applicable federal and state laws. Monitors pending privacy and security laws, industry standards, related news, and articles. Investigates and / or assists in the investigation of incidents and complaints and oversees the mitigation and resolution implemented. Conducts and / or reviews risk analysis of reported unauthorized disclosures.
• Tracks and follows-up on all compliance issues, including electronic maintenance. Prepares responses to inquiries from corporate compliance officials, attorneys, and regulatory agencies. Prepares and maintains business associate agreements as well as other required records. Creates specialized incident reports as requested.
• Manages the negotiation of Non-Disclosure Agreements associated with third-party vendor requests for the release of data containing confidential information for fully insured and self-funded accounts.
• Collaborates with Corporate Compliance on the development and updating of corporate-wide HIPAA privacy procedures and training programs. Serves as a resource to staff (customer service, marketing, etc.) as regulatory issues arise. Provides HIPAA training to area staff when requested by area management. Assists training department in developing on-going compliance awareness and knowledge training for employees.
• Works with legal counsel to ensure the corporation maintains appropriate forms and procedures and seeks legal advice on subjects as necessary. May serve as Compliance 360 administrator.
• Provides training and development of staff through mentoring and feedback.

Required Education : Bachelors Required Work Experience

5 years-health insurance industry, audit / compliance, contract administration, investigation, or-corporate level related experience. 2 years-demonstrated leadership experience in management / supervisory role, equivalent military experience in grade E4 or above (may be concurrent) or at least 5 years experience in a lead role.

Required Skills and Abilities

Comprehensive knowledge of laws, policies, procedures, and practices regarding privacy and security of protected health information, including HIPAA and HITECH. Strong interpersonal skills and ability to work professionally with persons at all levels. Ability to maintain effective working relationships. Ability to communicate clearly / effectively in oral and written form. Ability to handle sensitive matters on a confidential basis. Strong presentation, interviewing, organizational skills with strong attention to detail. Ability to exercise confidentiality and discretion. Excellent analytical, critical thinking and problem-solving abilities. Demonstrated organizational and time management skills with strong attention to detail. Highly effective verbal and written communication skills. Ability to use discretion, exercise good judgment and make sound decisions. Ability to demonstrate leadership and work with minimal supervision.

Required Software and Tools : Microsoft Office.

Our Comprehensive Benefits Package Includes The Following :

We offer our employees great benefits and rewards. You will be eligible to participate in the benefits at the first of the month following 28 days of employment :

What We Can Do for You :

We understand the value of a diverse and inclusive workplace and strive to be an employer where employees across all spectrums have the opportunity to develop their skills, advance their careers and contribute their unique abilities to the growth of our company.

What To Expect Next :

After submitting your application, our recruiting team members will review your resume to ensure you meet the qualifications. This may include a brief telephone interview or email communication with our recruiter to verify resume specifics and salary requirements.

Equal Employment Opportunity Statement :

BlueCross BlueShield of South Carolina and our subsidiary companies maintain a continuing policy of nondiscrimination in employment to promote employment opportunities for persons regardless of age, race, color, national origin, sex, religion, veteran status, disability, weight, sexual orientation, gender identity, genetic information or any other legally protected status. Additionally, as a federal contractor, the company maintains affirmative action programs to promote employment opportunities for individuals with disabilities and protected veterans. It is our policy to provide equal opportunities in all phases of the employment process and to comply with applicable federal, state and local laws and regulations.

We are committed to working with and providing reasonable accommodations to individuals with disabilities, pregnant individuals, individuals with pregnancy-related conditions, and individuals needing accommodations for sincerely held religious beliefs, provided that those accommodations do not impose an undue hardship on the Company.

If you need special assistance or an accommodation while seeking employment, please email mycareer.help@bcbssc.com or call 800-288-2227, ext. 47480 with the nature of your request. We will make a determination regarding your request for reasonable accommodation on a case-by-case basis.

We participate in E-Verify and comply with the Pay Transparency Nondiscrimination Provision. We are an Equal Opportunity Employer. Here's more information.

Some states have required notifications. Here's more information.