[Hiring] Sr. Ethics & Compliance Specialist @BCBST BlueCross BlueShield of Tennessee, Inc.

This description is a summary of our understanding of the job description. Click on 'Apply' button to find out more. Role Description Step into your next big career move as one of our compliance champions! With your strong background in claims processing, you'll play a pivotal role in monitoring Medicare Advantage Part C and D claims to ensure accuracy, integrity, and compliance across the board. Our Senior Ethics & Compliance Specialist role is where expertise meets purpose - you'll be safeguarding processes, supporting quality care, and driving excellence in one of the most impactful areas of healthcare. For seasoned claims professionals, this is more than a job; it's a chance to lead with confidence, champion compliance and make a meaningful difference every single day. Note: This is a fully remote role, but local candidates are preferred as travel to our Chattanooga, TN headquarters is expected once or twice per quarter.

• Interpreting and disseminating regulatory, compliance and contractual requirements for operational business functions.
• Monitoring and reviewing organizational procedures and policies to update compliance requirements.
• Leading the areas compliance program with the implementation of the approved monitoring workplan.
• Analyzing compliance issues, and providing solutions on regulatory, contractual, and compliance issues.
• Creating smooth cross departmental communication channels about ethics and compliance issues and solutions.

Qualifications

• Bachelor's Degree or equivalent work experience required.
• 5 years - Operations and/or Compliance experience required.

Requirements

• Ability to work independently with minimal supervision or function in a team environment sharing responsibility, roles and accountability.
• Demonstrated ability to interpret and translate regulatory and/or complex concepts into information meaningful to project team members and/or business personnel.
• Proficient in Microsoft Office (Outlook, Word, Excel and PowerPoint).
• Ability to work independently under general supervision and collaboratively as part of a team in a fast paced environment.
• Must be a team player, be organized and have the ability to handle multiple projects.
• Excellent oral and written communication skills.
• Strong interpersonal and organizational skills.
• Proven decision making and problem solving skills.
• Strong analytical skills.

Company Description

As Tennessee's largest health benefit plan company, we've been helping Tennesseans find their own unique paths to good health since 1945. More than that, we're your neighbors and friends – fellow Tennesseans with deep roots of caring tradition, a focused approach to physical, financial and community good health for today, and a bright outlook for an even healthier tomorrow. At BCBST, we empower our employees to thrive both independently and collaboratively, creating a collective impact on the lives of our members. We seek talented individuals who excel in a team environment, share responsibility, and embrace accountability. We're also seeking candidates who are proficient in the Microsoft Office suite, including Microsoft Teams, organized, and capable of managing multiple assignments or projects simultaneously. Additional, strong interpersonal abilities along with strong oral and written communication skills are important across all roles at BCBST. BCBST is a remote-first organization with many employees working primarily from their homes. Each position within the company is classified as either fully remote, partially remote, or office based. BCBST hires employees for remote positions from across the U.S. with the exception of the following states: California, Massachusetts, New Hampshire, New Jersey, and New York. Applicants living in these states may move to an approved state prior to starting a position with BCBST at their own expense. If the position requires the individual to reside in Chattanooga, TN, they may be eligible for relocation assistance. Apply tot his job Apply To this Job