Government Programs Compliance Medi-Cal Specialist, Consultant

Your RoleThe 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 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. 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 WorkIn 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.Conduct calibration of 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.Other duties as assigned.Your Knowledge and ExperienceRequires a bachelor's degree or equivalent experience.Requires at least 7 years of prior relevant experience.Has expert knowledge of Medicare or Medi-Cal regulatory compliance standards and processes.Professional certifications a plus.Additional degrees a plus.Pay Range:

The pay range for this role is $109,120.00 to $163,680.00 for California.

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