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Blue Cross Blue Shield of MichiganBM

Compliance Analyst

Blue Cross Blue Shield of Michigan is the largest health insurer in Michigan, serving 4.3 million members with accessible and innovative health care solutions.

Blue Cross Blue Shield of Michigan

Employee count: 5000+

Salary: 54k-91k USD

United States only

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SUMMARY:

This position will be involved with supporting enterprise compliance goals through research and analysis of regulatory claims and/or policy compliance items, assisting with the establishment and implementation of enterprise best practices, involvement with claims and product filings, and internal systems support. This position will also assist with development of enterprise compliance procedures and training and participate in compliance audits to ensure consistent application of compliance-driven processes throughout the enterprise.

RESPONSIBILITIES/TASKS:

  • Analyzes, research and reports on regulatory claims and/or policy compliance trends, issues, laws, rules, regulations and assists with the establishment and implementation of best practices.

  • Keeps abreast of compliance with the best practices and procedures for all applicable states and lines of business.

  • Assists with the development and implementation of reference materials, training programs, and other pertinent communications.

  • Assists in researching, developing, and providing input on compliance policies and procedures.

  • Assists in researching new states and/or lines of business for potential compliance concerns and provides educational material, as necessary.

  • Participates in compliance audits to ensure consistent application of compliance processes throughout enterprise, including determining audit parameters, reviewing files, analyzing results, and contributing to communication of audit findings.

  • Assists with researching and responding to questions and concerns from business units and others on compliance-related processes and decisions.

  • Assists with implementation and validation of compliance requirements for diversification efforts.

  • Tracks fines, fees and penalties related to claims and/or policy compliance for the enterprise.

  • Assist with review of fines, fees and penalties related to claim and/or policy compliance, including identifying root cause and identifying procedure gaps.

  • Other duties, as assigned.

This position description identifies the responsibilities and tasks typically associated with the performance of the position. Other relevant essential functions may be required.

EMPLOYMENT QUALIFICATIONS:

EDUCATION:

Bachelor’s degree in business administration, Finance or related field or the equivalent in relevant coursework and experience. Continuous learning required, as defined by the Company’s learning philosophy. Certification, or progress toward, highly preferred and encouraged. CPCU designation strongly preferred.

EXPERIENCE:

Compliance Analyst

Minimum two years’ experience in a Worker’s Compensation or Property & Casualty compliance environment, or equivalent. Thorough familiarity with Worker’s Compensation or Property & Casualty insurance concepts that provide the necessary skills, knowledge, and abilities.

SKILLS/KNOWLEDGE/ABILITIES (SKA) REQUIRED:

COMPLIANCE ANALYST:

  • Detail oriented.

  • Good organizational skills.

  • Ability to analyze and solve problems.

  • Above average verbal and written communication, interpersonal and customer service skills.

  • Knowledge of workers’ compensation insurance and underwriting techniques.

  • Knowledge of insurance operations, jurisdictional property and casualty laws, regulatory authorities and industry trends and their impact.

  • Proficient in Microsoft Windows including spreadsheet applications and Microsoft Word.

  • Ability to work independently, as well as within a team.

PAY RANGE:

Actual compensation decision relies on the consideration of internal equity, candidate’s skills and professional experience, geographic location, market, and other potential factors. It is not the standard practice for an offer to be at or near the top of the range, and therefore a reasonable estimate for this role is between $54,000 and $90,550.

WORKING CONDITIONS:

Work is performed in an office setting or remote setting with no unusual hazards. Minimal travel may be required with occasional overnight stays.

The qualifications listed above are intended to represent the minimum education, experience, skills, knowledge, and ability levels associated with performing the duties and responsibilities contained in this job description.

We are an Equal Opportunity Employer. Diversity is valued and we will not tolerate discrimination or harassment in any form. Candidates for the position stated above are hired on an "at will" basis. Nothing herein is intended to create a contract.

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About the job

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Salary

Salary: 54k-91k USD

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United States +/- 0 hours

About Blue Cross Blue Shield of Michigan

Learn more about Blue Cross Blue Shield of Michigan and their company culture.

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Through groundbreaking technology, we are revolutionizing health care at Blue Cross Blue Shield of Michigan. Founded in 1939, we are proud to be the largest nonprofit health insurer in Michigan and serve over 4.3 million members across the state and nation. Our mission is clear: we are dedicated to providing affordable, innovative products that enhance the health and well-being of our members. With a network of over 35,000 health care providers, we ensure our members have access to quality health care coverage when they need it most.

BCBSM strives to improve health outcomes through partnerships with local communities and health organizations. Our Building Healthy Communities program has positively impacted over 500,000 students in schools across Michigan. Additionally, our Strengthening the Safety Net initiative has contributed over $18 million to support health clinics that serve low-income populations. We believe that everyone deserves access to quality health care, which is why we focus on advancing health equity and reducing health disparities.

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Blue Cross Blue Shield of Michigan

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