Risk Adjustment Compliance, Sr. Principal jobs in United States
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Blue Shield of California · 2 weeks ago

Risk Adjustment Compliance, Sr. Principal

Blue Shield of California is committed to adherence to federal and state regulations, and they are seeking a Sr. Principal for their Risk Adjustment Compliance team. This role involves providing strategic leadership and management to ensure compliance with regulations related to Risk Adjustment across various lines of business, including oversight of risk assessments and monitoring compliance issues.

Financial ServicesHealth InsuranceNon Profit
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Responsibilities

Provide strategic leadership and management of the department overseeing compliance with regulations and laws related to Risk Adjustment across our Marketplace (ACA), Medicaid and Medicare lines of business
Oversee the development of risk assessments oversight and the monitoring of work plans pertaining to Risk Adjustment
Partner with business areas to ensure and implement effective prevention, detection and correction of compliance issues

Qualification

Risk Adjustment ComplianceRegulatory ComplianceStrategic LeadershipRisk AssessmentCollaboration

Required

Strategic leadership and management experience in compliance with regulations and laws related to Risk Adjustment
Experience overseeing compliance programs in Marketplace (ACA), Medicaid, and Medicare lines of business
Ability to implement elements of an effective compliance program
Experience in developing risk assessments and monitoring work plans related to Risk Adjustment
Ability to partner with business areas to ensure effective prevention, detection, and correction of compliance issues

Company

Blue Shield of California

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Blue Shield of California is a health insurance service provider.

Funding

Current Stage
Late Stage

Leadership Team

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Gary Culp
Senior Vice President, Government Markets
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Gregory Siebert
Senior Vice President Provider Partnerships & Network Management
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