BlueCross BlueShield of Tennessee

Compensation

Full Description

Senior Ethics & Compliance Specialist 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. Job Responsibilities • 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. Job Qualifications Education • Bachelor's Degree or equivalent work experience required. Equivalent experience is defined as 4 years of professional work experience in a corporate environment Experience • 5 years - Operations and/or Compliance experience required Skills/Certifications • 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 BlueCross BlueShield of Tennessee