Blue Shield of CA
Government Programs Compliance Medi-Cal Specialist, Consultant
Blue Shield of CA, Oakland, California, United States, 94616
Your Role
The Blue Shield of California Promise Health Plan Compliance team is responsible for the administration and oversight of an effective compliance program. The Government Programs Compliance Medi-Cal Specialist, Consultant will report to the Senior Manager, Government Programs Compliance Medi-Cal Manager. In this role you will be providing assistance with driving and managing the identification and scoping of impacts across cross-functional business areas due to ongoing, newly enacted, or federal and state regulatory requirements. You will collaboratively advise diverse business areas across the enterprise on the development of legally compliant solutions for newly enacted or revised Medicare or Medi-Cal requirements.
Your Work
In this role, you will:
Provide assistance with driving and managing the identification and scoping of impacts across cross-functional business areas due to ongoing, newly enacted, or federal and state regulatory requirements.Work collaboratively and advise diverse business areas across the enterprise on the development of legally compliant solutions for newly enacted or revised Medi-Cal requirements.Support the implementation of quality, repeatable, and documented CMS, DMHC, and DHCS regulatory compliance processes.Conduct decision-making guided by resource availability and functional objectives.Conduct audits of complex issues independently.Calibrate risk and controls with business units supporting the Medi-Cal line of business.Escalate and propose resolution for low to moderately complex CMS, DMHC, and DHCS regulatory and process issues.Support day-to-day operations of the Medi-Cal Compliance department.Support other Medi-Cal Compliance department initiatives and projects.Perform other duties as assigned.
Your Knowledge and ExperienceBachelor's degree or equivalent experience required.At least 7 years of prior relevant experience required.Expert knowledge of Medicare or Medi-Cal regulatory compliance standards and processes.Professional certifications are a plus.Additional degrees are a plus.Pay Range:
The pay range for this role is $109,120.00 to $163,680.00 for California.Note:
This range represents the pay range for this and many other positions at Blue Shield that fall into this pay grade. Blue Shield salaries are based on a variety of factors, including the candidate's experience, location (California, Bay area, or outside California), and current employee salaries for similar roles.
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The Blue Shield of California Promise Health Plan Compliance team is responsible for the administration and oversight of an effective compliance program. The Government Programs Compliance Medi-Cal Specialist, Consultant will report to the Senior Manager, Government Programs Compliance Medi-Cal Manager. In this role you will be providing assistance with driving and managing the identification and scoping of impacts across cross-functional business areas due to ongoing, newly enacted, or federal and state regulatory requirements. You will collaboratively advise diverse business areas across the enterprise on the development of legally compliant solutions for newly enacted or revised Medicare or Medi-Cal requirements.
Your Work
In this role, you will:
Provide assistance with driving and managing the identification and scoping of impacts across cross-functional business areas due to ongoing, newly enacted, or federal and state regulatory requirements.Work collaboratively and advise diverse business areas across the enterprise on the development of legally compliant solutions for newly enacted or revised Medi-Cal requirements.Support the implementation of quality, repeatable, and documented CMS, DMHC, and DHCS regulatory compliance processes.Conduct decision-making guided by resource availability and functional objectives.Conduct audits of complex issues independently.Calibrate risk and controls with business units supporting the Medi-Cal line of business.Escalate and propose resolution for low to moderately complex CMS, DMHC, and DHCS regulatory and process issues.Support day-to-day operations of the Medi-Cal Compliance department.Support other Medi-Cal Compliance department initiatives and projects.Perform other duties as assigned.
Your Knowledge and ExperienceBachelor's degree or equivalent experience required.At least 7 years of prior relevant experience required.Expert knowledge of Medicare or Medi-Cal regulatory compliance standards and processes.Professional certifications are a plus.Additional degrees are a plus.Pay Range:
The pay range for this role is $109,120.00 to $163,680.00 for California.Note:
This range represents the pay range for this and many other positions at Blue Shield that fall into this pay grade. Blue Shield salaries are based on a variety of factors, including the candidate's experience, location (California, Bay area, or outside California), and current employee salaries for similar roles.
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