CareFirst Careers

Director, Compliance and Ethics Development

Resp & Qualifications

PURPOSE
Provides the strategic development, design, implementation, promotion and maintenance of the Corporate Compliance and Ethics Program for the purpose of ensuring an ongoing culture of compliance and ethical behavior and the prevention of illegal or unethical behavior.  Advise and collaborate with other management and staff to promote a culture of compliance and ethical behavior, to continuously improve established practices and policies and to solve compliance issues and concerns.

ESSENTIAL FUNCTIONS

This position is responsible for designing, shaping and providing strategic leadership for the Compliance & Ethics Program. This position has matrixed oversight for all embedded compliance areas across the organization including management. Responsible for ensuring the organization maintains a robust, risk-based compliance and ethics program to help protect and grow our business. This includes periodic revisions and/or updates in response to new and emerging compliance areas, changes in the Company’s needs and statutory and regulatory requirements of the following documents and processes: the Compliance and Ethics Program, the Corporate Code of Ethical Business Conduct, the Contractor Code of Conduct, the Conflict of Interest Process and Compliance Certifications.

Strategically develop and expand the visibility and effectiveness of the Corporate Compliance and Ethics Program at all levels within the Company. Serve as the strategic leader of the Embedded Compliance throughout the organization. Maintain a cross-functional approach to compliance and ethics functions by coordinating efforts throughout the company and leveraging Embedded Compliance staff expertise and experience.

Direct and managing the Internal Investigations process, including strategic oversight and supervision relating to the overall planning and implementation of investigations. Partner with HR to conduct investigations and recommend action plans. Serve as subject matter expert on the proper procedure and process for conducting investigations and ensuring that all investigation information is maintained in the company's system.

Develop and participate in ongoing efforts to measure and improve the effectiveness of the Corporate Compliance and Ethics Program as required by the U.S. Federal Sentencing Guidelines for Corporations. Maintaining general knowledge of current laws and regulations that affect the Company in order to assist with corporate policy development, mandatory training and regulatory compliance issues.

Support Chief Compliance, Ethics & Privacy Officer with the development of training & presentations, budget management and representation at internal and external meetings as appropriate.

QUALIFICATIONS

Bachelor's Degree and 8 years experience with compliance and/or regulatory programs including the ability to read, interpret and implement regulations, polices and familiarity with related terminology and federal reporting and 3 years managerial experience.

Knowledge, Skills and Abilities (KSAs)                               
Strong analytical, interpersonal, and verbal communication skills. In addition, must possess clear, concise and persuasive writing and presentation skills – must influence and persuade all levels of associates in the organization. 

Maintains strong writing skills required to write and edit policies and procedures, issue memorandums and compile program reports. 

Must have the ability to follow instructions, to be flexible/versatile, and to work independently with minimal supervision. 

Solid PC skills such as Microsoft Office Suite (Excel, PowerPoint, Word) as well as familiarity with automated tracking databases. 

Additional Skills and Abilities

  • Experience in state and federal regulatory oversight is essential.
  • Familiarity with operational, financial, quality assurance, and human resources procedures and regulations in the health insurance field.
  • Familiarity with Governance Risk and Compliance concepts and software capabilities.

#LI-KL1

Equal Employment Opportunity

CareFirst BlueCross BlueShield is an Equal Opportunity (EEO) employer.  It is the policy of the Company to provide equal employment opportunities to all qualified applicants without regard to race, color, religion, sex, sexual orientation, gender identity, national origin, age, protected veteran or disabled status, or genetic information.

Hire Range Disclaimer

Actual salary will be based on relevant job experience and work history.

Where To Apply

Please visit our website to apply: www.carefirst.com/careers

Closing Date

Please apply before: 7.8.21

Federal Disc/Physical Demand

Note:  The incumbent is required to immediately disclose any debarment, exclusion, or other event that makes him/her ineligible to perform work directly or indirectly on Federal health care programs.

PHYSICAL DEMANDS:

The associate is primarily seated while performing the duties of the position.  Occasional walking or standing is required.  The hands are regularly used to write, type, key and handle or feel small controls and objects.  The associate must frequently talk and hear.  Weights up to 25 pounds are occasionally lifted.

Sponsorship in US

Must be eligible to work in the U.S. without Sponsorship

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