Job Summary
JOB DESCRIPTION
Contract Compliance & Regulatory Specialist apply discipline-specific or institutional knowledge and skills in the performance of departmental activities which support the Company's operations. In this role, the Contract Compliance & Regulatory Specialist will utilize their expertise to audit and oversee programs, policies, and practices to ensure full compliance with state and federal contracts, as well as legal and regulatory requirements. This will involve presenting audit findings and relevant information to Senior Management and/or designated audit committees on a continuous basis. As a subject matter expert and liaison, this employee will provide guidance on adherence to regulations or laws that may impact agreement terms and conditions, particularly as they relate to suppliers with whom our organization has contracted. Typically, Specialists prepare for their role by earning a post-secondary degree in a specific field, obtaining certification, or by on-the-job training and work experience. Incumbents may directly manage a small number of direct reports; however, the primary function of the role is applying specialized knowledge and skills as an exempt-level individual contributor.
Note: This role has the ability to be remote, hybrid, or on-site based on employee needs or preferences.
What You Will Be Doing
- Serve as a liaison between internal clients and functional departments (Legal, Third Party Risk Management, Business Ethics, & Integrity (BEIC); help clients achieve their objectives by serving as a resource in the interpretation, application and compliance with internal and external laws, regulations, policies, procedures, standards and practices.
- Seek to ensure that government agencies, contract holders and in some cases, grant recipients, are complying with government standards regarding Equal Opportunity Employment
- Support the audit manager with requests; assists many aspects or coordination and ensures timing, key contacts, subject matter experts, so as to deliver complete documents and correct data
- Identify risks, evaluate controls and prepare findings and recommendations. Implement compliance programs to prevent illegal, unethical or improper business practices.
- Ensure through audits that the organization’s programs are consistently administered in compliance with organizational policies and procedures, contractual obligations, rulings, laws and government regulations.
- Connect with external key integration points such as Blue Cross and Blue Shield Association Director’s Office Federal Employee Program’s (Office for Program Management) in order to remain in compliance and to coordinate required training.
- Monitor and evaluate the effectiveness of solutions, policies, practices, and processes to ensure continuous improvement, good client relations and adherence to business requirements. Recommend improvements to achieve and deliver high quality, value-added services.
- Develop, implement, administer, and revise policies, procedures and programs that meet business needs; assist and/or lead program development and enhancements.
- Research, analyze, maintain, modify, validate, and prepare data, information and content used in making business decisions. Present findings and articulate results.
- Produce, edit, and distribute a variety of business documents such as reports, proposals, policies, procedures, audit results, issue papers, marketing materials, newsletters, brochures, etc.
- Create, present and/or facilitate meetings, webinars, conference calls, training programs, education sessions, certifications, etc. for a variety of internal and external audiences.
- Represent assigned function at external hearings, mediations, audits, meetings, etc.
- Participate on or lead large, complex departmental and/or divisional projects. Plan, organize, monitor, and control projects to ensure the effective use of resources and adherence to project management standards and reporting requirements.
- Participate on Company workgroups and initiatives.
- Develop and build internal and external partnerships to improve communication, coordination, collaboration, and effective working relationships within own department, across the Company and outside of the Company.
- With minimal supervision, accurately ascertain, manage the associated due diligence regarding, and contractually address the implications of FEP, CMS, QHP, State Group, HIPAA, HITECH, etc. requirements.
- Mentor and coach less experienced coworkers on the technical and interpersonal skills needed for effective job performance.
- The essential functions listed represent the major duties of this role, additional duties may be assigned.
What You Must Have
5+ years related work experience. Experience Details: corporate level experience in compliance, project management, analysis, procurement, contract review, or other relevant professional work experience.
Related Bachelor’s degree or additional related equivalent work experience
Demonstrated working knowledge with Microsoft Office products is required (Word, Excel, Outlook, SharePoint, PowerPoint, etc.)
Analytical Skills
General Physical Demands
Sedentary work: Exerting up to 10 pounds of force occasionally to move objects. Jobs are sedentary if traversing activities are required only occasionally.
What We Offer
As a Florida Blue employee, you will thrive in our Be Well, Work Well, GuideWell culture where being well as an individual, and working well as a team, are both important in serving our members and communities.
To support your wellbeing, comprehensive benefits are offered. As an employee, you will have access to:
- Medical, dental, vision, life and global travel health insurance;
- Income protection benefits: life insurance, Short- and long-term disability programs;
- Leave programs to support personal circumstances;
- Retirement Savings Plan includes employer contribution and employer match;
- Paid time off, volunteer time off, and 11 holidays
- Additional voluntary benefits available; and
- A comprehensive wellness program
Employee benefits are designed to align with federal and state employment laws. Benefits may vary based on the state in which work is performed. Benefits for intern, part-time and seasonal employees may differ.
To support your financial wellbeing, we offer competitive pay as well as opportunities for incentive or commission compensation. We also conduct regular annual reviews with pay for performance considerations for base pay increases.
Typical Annualized Hiring Range: $74,200 - $85,000
Annualized Salary Range: $74,200 - $120,500
Final pay will be determined with consideration of market competitiveness, internal equity, and the job-related knowledge, skills, training, and experience you bring.
We are an Equal Opportunity/Protected Veteran/Disabled Employer committed to creating a diverse, inclusive and equitable culture for our employees and communities.
About Us
At GuideWell, we are committed to making diversity, equity and inclusion part of everything we do. We believe in hiring people who represent the communities we serve while creating a workplace that encourages a sense of belonging for everyone, no matter who you are or where you come from.
From students to former military to seasoned professionals, our family of mission-based companies are stronger because of the unique talents and skills of our employees. We believe everyone’s contribution has the power to help people and communities achieve better health. Find your new team today.
About The Team
Florida Blue, A GuideWell Company, has been providing health insurance to residents of Florida for 75 years. Driven by its mission of helping people and communicating to achieve better health, the company serves more than five million health care members across the state. We are looking for exceptional people who will bring our mission to life and succeed by putting the members first.