Senior Director, Compliance and Ethics

Blue Shield of CA; California, Long Beach (MO, CA); On-site; USD 120,000 - 180,000; Full time

Job summary

An established industry player is seeking a Senior Director for Compliance & Ethics to oversee and enhance its enterprise-wide compliance program. This pivotal role requires extensive experience in health care compliance and ethics, along with strong leadership skills to manage a diverse team. The ideal candidate will possess a robust understanding of compliance regulations and a proven track record in developing effective policies and procedures. Join a forward-thinking organization that values integrity and ethics, and contribute to a culture of compliance that ensures the highest standards are met across all operations. This is an exceptional opportunity to make a significant impact in the health care sector.

Qualifications

• 12+ years of experience in health care compliance and ethics.
• Strong leadership and management experience required.

Responsibilities

• Lead the enterprise-wide Compliance & Ethics program.
• Implement and maintain compliance policies and training.

Skills

Compliance Program Management

Health Care Legal Experience

Leadership Skills

Policy Writing

Risk Assessment

Communication Skills

Analytical Thinking

Education

Bachelor's Degree

Juris Doctor (JD)

Tools

Compliance Management Software

Job description

Your Role

This role will act as Blue Shield of California's (BSC's) Senior Director, Compliance & Ethics. BSC's Compliance & Ethics Department is part of BSC's larger Corporate Integrity and Risk Management. BSC Corporate Compliance & Ethics owns and coordinates the Company's compliance and ethics program across the enterprise, including all business units, products, services and activities. The Compliance & Ethics program includes the implementation and maintenance of proper preventive, detective and remedial programs and controls; the execution of relevant policies and procedures; training and educating the workforce; implementing an effective communications program; ensuring effective testing, auditing, monitoring, tracking and reporting; and remediating control deficiencies.

The Compliance & Ethics program encompasses many subject matter areas, including Code of Conduct, Corporate Compliance policy management, compliance training, compliance investigations, anti-bribery, -kickback and -corruption, exclusion lists, Conflict of Interest program management, and other compliance and ethics initiatives. The role will report directly to BSC's Vice President, Chief Risk and Compliance Officer. While this role will spend most of its time leading our enterprise-wide Compliance & Ethics program, it may serve in additional capacities and assist in other initiatives, as needed.

Your Knowledge and Experience

• Bachelor's Degree and a minimum of 12 years of substantive health care legal, compliance and ethics experience with increasingly progressive responsibility including Director-level Compliance experience and 8 years of management/leadership experience required.
• Juris Doctor (JD) from an ABA accredited law school and admission to practice law in California is preferred.
• Functional subject matter expertise in Codes of Conduct, compliance investigations, compliance hotlines/reporting, compliance training and communications, anti-corruption/anti-bribery/anti-kickback, government contracting, exclusion lists, corporate ethics, business partner and third-party risk management, and applicable laws, regulations and standards including anti-fraud, anti-corruption, Federal Sentencing Guidelines, U.S. Department of Health, and Human Services (DHHS) Officer of Inspector General (OIG) and Centers for Medicare and Medicaid Services (CMS) guidance on effective compliance programs.
• Demonstrated experience with writing and implementing policies and procedures, performing risk assessments, documenting controls and control gaps, remediating control gaps, and delivering and maintaining a robust and effective compliance and ethics program.
• Must possess excellent verbal and written communication and relationship building skills to effectively interact with senior management team, board members, providers, and federal and state regulators. Strong independent judgment, problem-solving, critical, and analytical thinking skills, including a "moral compass" and high integrity.
• Certified Healthcare Certification (CHC) or Certified Compliance and Ethics Professional Certification (CCEP), and experience and knowledge of compliance or risk incident management software preferred.