Senior Network Compliance Lead

Blue Shield of CA; Long Beach (CA); Hybrid; USD 140,000 - 190,000; Full time

Benefits offered by this job

Hybrid workplace model

Two days in-office per week

Job summary

Blue Shield of CA is seeking a Network Compliance Manager, Principal, to lead regulatory compliance across Commercial, Medicare Advantage, and Medi-Cal provider networks.

You will serve as the primary liaison with state regulators and plan partners, guiding filings and notices while resolving complex compliance issues. This role emphasizes leadership development, critical thinking, and cross-team collaboration in a hybrid in-office model.

Qualifications

• 4 years of additional relevant experience in lieu of a degree.
• 10 years of prior relevant experience.
• 5+ years of progressive experience in health plan compliance.
• DMHC experience and block transfer experience preferred.
• Strong interpersonal and verbal and written communication skills.
• Works independently under limited supervision.
• Detail oriented with ability to handle complexity and shifting priorities.
• Advanced proficiency with MS Office (Word, PowerPoint, Excel).
• CHC designation or related credential preferred.

Responsibilities

• Serve as the primary liaison with state regulators and plan partners.
• Oversee compliance with evolving state requirements across Commercial, Medicare Advantage, and Medi-Cal.
• Lead regulatory initiatives including block transfers and termination transition planning.
• Manage member notification processes and required state filings.
• Maintain strong regulatory relationships while resolving complex issues.

Skills

Regulatory liaison

Health plan compliance

DMHC experience

Block transfers

Provider termination planning

Verbal communication

Written communication

Independent work

Detail oriented

MS Office (Word, PowerPoint, Excel)

Education

Bachelor's degree

High School Diploma/GED

CHC designation or related credential

Job description

Blue Shield of CA is seeking a Network Compliance Manager, Principal, to lead regulatory compliance across Commercial, Medicare Advantage, and Medi-Cal provider networks.

You will serve as the primary liaison with state regulators and plan partners, guiding filings and notices while resolving complex compliance issues. This role emphasizes leadership development, critical thinking, and cross-team collaboration in a hybrid in-office model.