We are seeking a strategic and experienced compliance professional to lead enterprise-wide initiatives and serve as a trusted advisor across multiple business units.
In this role, you will drive complex compliance projects, provide expert regulatory guidance, mentor team members, and serve as a compliance subject matter expert. You will also support Tennessee Department of Commerce and Insurance (TDCI) contract submissions and regulatory interactions for the BlueCare line of business requiring strong regulatory acumen. Ideal candidates bring deep compliance expertise—Medicaid experience is a plus. Strong candidates will have advanced-level skill set with Microsoft Office along with experience leveraging AI tools to enhance compliance workflows and solve complex challenges.
Note: Sponsorship is not available for this role.
Job Responsibilities
- Coordination of highly sensitive reviews conducted by government agencies such as TDCI, CMS, OPM/FEP, DOL, etc.
- Assist on special assignments and workgroups concerning enterprise level compliance processes and enhancements.
- Serves as a subject matter expert in regulatory research and interpretation, data analysis, audit principles, project management techniques, and general knowledge of industry best practices.
- Serves as a representative for Corporate Compliance with both internal and external groups.
- Manages scope and leads multiple projects including the execution of successful change management processes as requested by leadership.
- Overseeing project processes and procedures; monitoring the productivity and performance of project team. Tracks, reports and resolves issues, evaluates project activities, builds contingency plans and executes corrective action when necessary.
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
- 8 years of experience in health care compliance and/or experience with government regulations and compliance obligations required
- Project management experience required
- Demonstrates a deep understanding and expertise of core compliance, ethics and regulatory concepts
Skills/Certifications
- Possess or be eligible to obtain an appropriate industry designation involving compliance, audit, fraud or information compliance as applicable within 2 years of hire
- Ability to work independently with minimal supervision or function in a team environment sharing responsibility, roles and accountability.
- Proficient in Microsoft Office (Outlook, Word, Excel, Access and PowerPoint)
- Excellent oral and written communication and presentation skills
- Strong interpersonal and organizational skills
Number of Openings Available
1Worker Type:
EmployeeCompany:
BCBST BlueCross BlueShield of Tennessee, Inc.Applying for this job indicates your acknowledgement and understanding of the following statements:
BCBST will recruit, hire, train and promote individuals in all job classifications without regard to race, religion, color, age, sex, national origin, citizenship, pregnancy, veteran status, sexual orientation, physical or mental disability, gender identity, or any other characteristic protected by applicable law.
Further information regarding BCBST's EEO Policies/Notices may be found by reviewing the following page:
BCBST's EEO Policies/Notices
BlueCross BlueShield of Tennessee is not accepting unsolicited assistance from search firms for this employment opportunity. All resumes submitted by search firms to any employee at BlueCross BlueShield of Tennessee via-email, the Internet or any other method without a valid, written Direct Placement Agreement in place for this position from BlueCross BlueShield of Tennessee HR/Talent Acquisition will not be considered. No fee will be paid in the event the applicant is hired by BlueCross BlueShield of Tennessee as a result of the referral or through other means.
Skills Required
- Bachelor's Degree or equivalent work experience
- 8 years of experience in health care compliance and/or government regulations
- Project management experience
- Possess or be eligible for an industry designation involving compliance, audit, or fraud
- Proficient in Microsoft Office
What We Do
As Tennessee's largest health plan, we've been helping Tennesseans find their own unique paths to good health for more than 70 years. 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. Our mission is simple: peace of mind through better health. We're an independent, not-for-profit, locally governed health plan company – meaning we live and work alongside our Tennessee business customers and plan members. Our 6,000 employees across the state have built our strong reputation for integrity, excellent service and community leadership. But we are also part of the BlueCross BlueShield Association, a nationwide association of health care plans. Because of this, our plan members have access to the same quality health benefits while traveling or living out of state that they have while in Tennessee. © 2018 BlueCross BlueShield of Tennessee, Inc., an Independent Licensee of the BlueCross BlueShield Association.
