The hiring range for this role is:  

92,086.00 - 129,145.00

This is the lowest to highest salary we, in good faith, believe we would pay for this role at the time of this posting.  We may ultimately pay more or less than the hiring range and this hiring range may also be modified in the future. A candidate’s position within the hiring range may be based on several factors including, but not limited to, specific competencies, relevant education, qualifications, certifications, relevant experience, skills, seniority, performance, shift, travel requirements, and business or organizational needs. This job is also eligible for annual bonus incentive pay. 

We offer a comprehensive package of benefits including paid time off, 11 holidays, medical/dental/vision insurance, generous 401(k) matching, lifestyle spending account and many other benefits to eligible employees. 

Note: No amount of pay is considered to be wages or compensation until such amount is earned, vested, and determinable. The amount and availability of any bonus, commission, or any other form of compensation that are allocable to a particular employee remains in the Company's sole discretion unless and until paid and may be modified at the Company’s sole discretion, consistent with the law. 

 

This role evaluates compliance with regulations and develops corrective action plans. Deliver training to BCBSA and Plans, handling complex issues. Act as a resource and consultant on audit activities, developing programs, policies, and procedures to prevent abuse. Leads and support projects, provides guidance on budget, costs, service charges, and incentives.

Primary Job Functions

Evaluates the level of compliance with applicable federal regulations, contractual requirements and procedures at BCBSA and Plans. Maintain the BCBSA compliance plan as part of these activities and serves as the main point of contact for BCBSA and Plans financial and claims audits.

Serves as subject matter expert for BCBSA financial policies and procedures BCBSA and Plans regarding the audit process; instructs audit flow facilitation; analyzes and assesses audit trends, best practices and risk; and develops an overall and effective audit program.

Assists leaders with other assignments on an ad hoc basis.

Develops and presents training to BCBSA and Plans as it relates to all types of audits.

Education, Experience, and Certification

Education

Required: Bachelor’s degree in accounting, business, finance or related field, or equivalent experience

Experience
Required:

Minimum of 4 years of related work experience, including progressively more complex assignments; proficiency with Microsoft Office or similar software (Excel, Word, PowerPoint, Outlook).

Preferred: Experience in health care or government contracting environment; Blues Plan experience
 

Certifications

Preferred Certification: Financial Services\Certified Public Accountant (CPA)

Preferred Certification: Healthcare / Insurance\ACMA - ACM - Certified Case Management Preferred Certification: Legal, Risk, Contracts & Governance\IIA - Certified Internal Auditor (CIA ​


Knowledge, Skills, and Experience

Intermediate knowledge of auditing, finance and claims operations

Demonstrate advanced negotiation, analytical, and problem solving skills, as well as strong project management, interpersonal, and organizational skills

Ability to take complex audit issues and seek resolution

Demonstrate ability to develop and maintain business relationships, as well as the ability to create strategies that support initiatives and translate these into action plans

Ability to direct customers and related parties through influence rather than authority; excellent written, oral and presentation skills.

Financial Responsibilities
Revenue Management: No

Budget Management: No

People Management: No

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