This Business Support Consultant will design, develop, execute and lead Federal, State and BCBSA programs, projects and initiatives designed to attain and maintain regulatory compliance across the enterprise; serving as spokesperson on behalf of the Company to effectively communicate and influence external entities (e.g. United States Congress, CMS, HFMA, business partners, delegated entities, and subsidiaries) regarding corporate positions on regulatory matters.
Primary Job Functions:
- Provide technical integration and business process operational regulatory adherence guidance, direction and support.
- Work extensively with external industry work groups, medical associations and societies to position Florida Blue as a leader in regulatory compliance programs.
- Provide subject matter expertise and is delegated as a corporate expert witness across Federal, State and BCBSA regulatory mandates with legal and corporate compliance staff.
- Establish and maintain strong working and on-going relationships with Federal and State regulatory agencies, BCBSA Blue Plans, other competitive health plans, various industry consultants, electronic trading partners, Availity and applicable heath care industry workgroups that are focused on regulatory compliance programs, initiatives and their implementations.
Minimum Job Requirements:
- Bachelor's degree in related discipline.
- 10+ years' hands on technical experience.
- 15+ years' experience working with Federal, State and BCBSA regulatory mandates and compliance related programs, projects and initiatives.
- 10+ years' experience in initiating, implementing and supporting technical and business process changes designed to meet Federal, State and BCBSA regulatory mandates and sustained adherence.
- Strong organizational, facilitation, communication and presentation skills.
- Strong interpersonal skills and the ability to influence and accomplish results through others, including persons not in the "chain of command".
- Health care and regulatory compliance related certifications.
- Project management experience.