- Gather relevant data and Key Performance Indicators for compliance reports and dashboards, and prepare reports based on established reporting metrics for the group.
- Develop and update Standard Operating Policies and Procedures (SOP) for review processes and compliance. Educate stakeholders on these SOPs.
- Conduct risk assessments and identify potential non-compliance vulnerabilities and make practical business recommendations to correct non-compliance or improve insufficient processes.
- Knowledge of the sources of legal and regulatory requirements relevant to state and federal requirements.
- Knowledge of the Federal and State regulatory environment in the health insurance industry, with emphasis on CMS Medicare/Part D federal mandates,
- Understanding of best practice internal ethics and compliance programs.
- Excellent at organizing, managing, and handling competing projects with a proven ability to meet tight deadlines in a fast-paced environment.
- Skilled at managing a high volume of work with changing priorities and frequent interruptions while maintaining the ability to work cooperatively with a positive attitude.
- Written and oral communication.
- Facilitation, active listening, and presentation skills.
- Critical thinking skills and the ability to apply an analytical approach to regulatory research and issue remediation.
- Persuasion/negotiation and interpersonal relationship skills and the ability to effectively interact and collaborate with individuals at all levels within the organization.
- Problem solving acumen. Ability to identify potential noncompliance issues, obtain information to clarify and describe issue, exercise sound decision-making, resolve problems using appropriate risk treatment, and leverage appropriate escalation pathways.
- High degree of discretion in dealing with the confidentiality of all compliance-related issues.
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Compliance Analyst
3 days ago
Addison Group Chicago, United StatesOur client in the Legal space is seeking a Compliance Analyst to join their team on a DIRECT HIRE basis. Ideal candidates will have 1+ years of compliance related experience and have a bachelors degree. · Job Title: Compliance Analyst · Location: Chicago, IL · Pay Range: $65,00 ...
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Compliance Analyst
11 hours ago
HUB International Chicago, United StatesABOUT US · At HUB International, we are a team of entrepreneurs. We believe in empowering our clients, and we do so by protecting businesses and individuals in our local communities. We help businesses evaluate their risks and develop solutions tailored to their needs. We believe ...
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Compliance Analyst
9 hours ago
Hub International Chicago, United StatesABOUT US · At HUB International, we are a team of entrepreneurs. We believe in empowering our clients, and we do so by protecting businesses and individuals in our local communities. We help businesses evaluate their risks and develop solutions tailored to their needs. We believe ...
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Compliance Analyst
9 hours ago
Sidley Austin LLP Chicago, United StatesSummary · The HR Analyst reports to the Global Compliance Manager and is responsible for working closely with the Compliance Specialists to support the firm's compliance program, global mobility program and HR-related DEI data needs. · Duties and Responsibilities · * Maintain com ...
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Compliance Analyst
4 days ago
Addison Group Chicago, United StatesJob Title: Compliance Analyst · Location: Chicago Loop – 5 days onsite for training, then hybrid capability · Industry: Legal · Pay: $65,000 - $70,000 per year · About Our Client: Our client, a leading firm in the legal industry, is seeking a diligent and detail-oriented Complian ...
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Compliance Analyst
1 day ago
EquiTrust Chicago, United StatesThe Compliance Analyst (Advertising Review) plays a crucial role in upholding the integrity and regulatory compliance of all advertising and marketing materials. This Compliance Analyst is responsible for ensuring and enabling the adherence to advertising compliance policies by r ...
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Compliance Analyst
2 days ago
Addison Group Chicago, United StatesOur client in the Legal space is seeking a Compliance Analyst to join their team on a DIRECT HIRE basis. Ideal candidates will have 1+ years of compliance related experience and have a bachelors degree. · Job Title: Compliance Analyst · Location: Chicago, IL · Pay Range: $65,0 ...
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Compliance Analyst
1 day ago
Gresham Partners, LLC Chicago, United StatesFounded in 1997, Gresham Partners, LLC is a $8 billion Chicago-based investment and wealth management firm serving a select group of ultra-high-net-worth families across the country. The firm is known for its independent thinking, investment approach, and performance results. Gre ...
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Compliance Analyst
3 days ago
HUB International Chicago, United StatesABOUT US · At HUB International, we are a team of entrepreneurs. We believe in empowering our clients, and we do so by protecting businesses and individuals in our local communities. We help businesses evaluate their risks and develop solutions tailored to their needs. We believ ...
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Compliance Analyst
1 day ago
Gresham Partners LLC Chicago, United StatesFounded in 1997, Gresham Partners, LLC is a $8 billion Chicago-based investment and wealth management firm serving a select group of ultra-high-net-worth families across the country. The firm is known for its independent thinking, investment approach, and performance results. Gre ...
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Compliance Analyst
2 days ago
Sidley Austin Chicago, United StatesSummary: · The HR Analyst reports to the Global Compliance Manager and is responsible for working closely with the Compliance Specialists to support the firms compliance program, global mobility program and HR-related DEI data needs. · Duties and Responsibilities: Maintain comp ...
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Analyst - Compliance
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Bally's Corporation Chicago, United StatesAbout Bally's: · Bally's Corporation is one of the world's leading entertainment companies, with millions of players across digital gaming platforms and traditional casino venues. Recognized for our innovation, energy, and dedication to creating thrilling gaming experiences, we ...
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Analyst - Compliance
10 hours ago
Bally's Corporation Chicago, United StatesAbout Bally's: · Bally's Corporation is one of the world's leading entertainment companies, with millions of players across digital gaming platforms and traditional casino venues. Recognized for our innovation, energy, and dedication to creating thrilling gaming experiences, we w ...
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Compliance Analyst
5 days ago
Addison Group Chicago, United StatesJob Description · Job DescriptionJob Title: Compliance Analyst · Location: Chicago Loop – 5 days onsite for training, then hybrid capability · Industry: Legal · Pay: $65,000 - $70,000 per year · About Our Client: Our client, a leading firm in the legal industry, is seeking a dil ...
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Compliance Analyst
3 days ago
Living Talent Company Chicago, United StatesInvestment Management Firm (100B+ AUM) Hybrid, 3 days in office in Chicago Loop · Full relocation available · Base + Bonus 120k - 140k · Robust benefits package · Role & Responsibilities CRIMS policy implementation. · Governing Document Review: Interpret investment agreeme ...
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Compliance Analyst
2 days ago
MAVEN Chicago, United StatesMaven is a proprietary trading organization founded in 2011. We employ some of the most talented traders, developers, and engineers in the market, executing a diverse range of strategies across global equities and derivatives. Maven has a culture that is relaxed and informal and ...
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Compliance Analyst
4 days ago
Maven Securities Chicago, United States Full timeMaven is a proprietary trading organization founded in 2011. We employ some of the most talented traders, developers, and engineers in the market, executing a diverse range of strategies across global equities and derivatives. Maven has a culture that is relaxed and informal and ...
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Compliance Analyst
2 weeks ago
Sidley Austin LLP Chicago, United States Regular, Full time· Compliance Analyst · Recruiting Location · US-IL-Chicago · Department · Human Resources · Summary · The HR Analyst reports to the Global Compliance Manager and is responsible for working closely with the Compliance Specialists to support the firm's compliance program, global m ...
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Compliance Analyst
3 days ago
Living Talent Company Chicago, United StatesInvestment Management Firm (100B+ AUM) · Hybrid, 3 days in office in Chicago Loop · Full relocation available · Base + Bonus 120k - 140k · Robust benefits package · Role & Responsibilities · CRIMS policy implementation. · Governing Document Review: Interpret investment agreemen ...
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Analyst - Compliance
1 week ago
Bally's Corporation Chicago, United States Regular, Full time· About Bally's: · Bally's Corporation is one of the world's leading entertainment companies, with millions of players across digital gaming platforms and traditional casino venues. Recognized for our innovation, energy, and dedication to creating thrilling gaming experiences, w ...
Medicare Compliance Analyst - Chicago, United States - Blue Cross Blue Shield Association
Description
Location Chicago
This position enacts, monitors, and operationalizes multiple components of the BCBSA Medicare Part D Compliance Program (MPDP) , as well as the FEP Medicare Prescription Drug Program.
Act as liaison with third party compliance help line vendor; investigate potential internal BCBSA compliance issues. Develop internal training programs to ensure compliance with regulatory requirements.
Support Medicare Compliance Officer by: maintaining current CMS policies; ensure various HHS contract requirements met, including the training/tracking of all new and current applicable employees and FEP BOM members; monitoring, investigation, and resolution of any member ethics complaints/allegations; completing all required internal/external reporting requirements; ensure monthly screening of employees, FEP BOM members, and applicable FDRs is completed and discrepancies resolved.
Education
Bachelors Degree
Compliance/legal, business operations preferred
Certifications
Certified Compliance & Ethics Professional Certification (CCEP) - Compliance Certification Board
Certified in Healthcare Compliance (CHC) - Compliance Certification Board
Leadership Professional in Ethics & Compliance (LPEC) - Ethics and Compliance Institute
Experience
Requires a minimum of five (2) to 4 years of relevant compliance experience in a healthcare or managed care environment.
Requires a minimum of three (2) years experience in the interpretation and application of federal and state regulations, policies and procedures, and ethical principles related to healthcare compliance.
Skills
People Management
No
#Hybrid#
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