New

Senior Compliance Specialist - Hybrid

Blue Cross Blue Shield of Arizona
United States, Arizona, Phoenix
May 16, 2025
Awarded a Healthiest Employer, Blue Cross Blue Shield of Arizona aims to fulfill its mission to inspire health and make it easy.AZ Blue offersa 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. At AZ Blue, we have a hybrid workforce strategy, called Workability, that offers flexibility with how and where employees work. Our positions are classified as hybrid, onsite or remote. While the majority of our employees are hybrid, the following classifications drive our current minimum onsite requirements: Hybrid People Leaders: must reside in AZ, required to be onsite at least twice per week Hybrid Individual Contributors: must reside in AZ, unless otherwise cited within this posting, required to be onsite at least once per week Hybrid 2 (Operational Roles such as but not limited to: Customer Service, Claims Processors, and Correspondence positions): must reside in AZ, unless otherwise cited within this posting, required to be onsite at least once per month Onsite: daily onsite requirement based on the essential functions of the job Remote: not held to onsite requirements, however, leadership can request presence onsite for business reasons including but not limited to staff meetings, one-on-ones, training, and team building Please note that onsite requirements may change in the future, based on business need, and job responsibilities. Most employees should expect onsite requirements and at a minimum of once per week. PURPOSE OF THE JOB Oversees BCBSAZ identification, tracking and evaluation of new and updated mandates to ensure compliance with all applicable requirements. Manage regulatory reporting activities and submissions on behalf of AZ Blue to various organizations, including but not limited to the Arizona Department of Insurance and Financial Institutions, Arizona Corporate Commissions, and federal agencies. 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 Required Work Experience 5 years of experience with government or compliance, privacy, or legal issues Required Education High School Diploma or equivalent. Bachelor's degree in legal studies, compliance, or other related field of study. Required Licenses N/A Required Certifications N/A PREFERRED QUALIFICATIONS Preferred Work Experience 7 years' experience with compliance, privacy, government programs or legal issues in a healthcare industry Preferred Education Master's degree in business or healthcare field of study. Preferred Licenses Paralegal certificate. Preferred Certifications Advanced compliance professional or legal training ESSENTIAL JOB FUNCTIONS AND RESPONSIBILITIES Performs end-to-end research, preparation and submission of regulatory filings in compliance with legal, the Blue Cross Blue Shield Association, and regulatory requirements. Work collaboratively with various internal partners to prepare and submit required reports, forms, and documents while ensuring accurate and timely regulatory report submissions. Assess existing regulatory reporting processes and develop recommendations to improve efficiency and effectiveness. Maintain document management system for audit and retention of the various regulatory reporting submissions. 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. Apply data analytics techniques, to examine, interpret, and report results for leaders to make data-driven decisions. Oversee the Governance, Risk and Controls (GRC) processes and tools, to ensure it is aligned with our organization's strategic priorities and regulatory obligations. 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. 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. Manages projects with multi-disciplinary teams. Acquires and maintains an in-depth knowledge of legal requirements, current government or corporate compliance and ethics, industry practices. Serves as subject matter expert. Mentors and cross trains with other Compliance staff. 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 Required Job Skills 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 Required Professional Competencies Proficient in legal research and understanding of legal terminology, and procedures. 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 Required Leadership Experience and Competencies Take appropriate risks using available data Build synergy with a diverse team in an ever-changing environment. PREFERRED COMPETENCIES 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 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. Preferred Leadership Experience and Competencies N/A Our Commitment AZ Blue 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.