Do what you love. Love what you do.

Our very competitive package of Employee Benefits includes everything from tuition reimbursement to 401(k) savings plans.

Position Description

Arkansas Blue Cross and Blue Shield - EXEMPT POSITION DESCRIPTION

Return
Position:  Compliance Analyst - EDS
Reports To: 
Division:  Enterprise Devlpmt Svcs (0045)
Company:  ABCBS
Location:  Label
Job Code:  039958
Min Salary:   44900
Date:  4/4/2013

Apply for position    Email to a friend

Position Specific Requirements: Need to meet all requirements, and provide samples of user manual documentation.


Job Summary
The Compliance Analyst - EDS is a technical professional team member who is responsible for managing system implementation and maintenance, upgrades, testing, and user documentation. He/she actively pursues the entity-wide objective of maintaining compliance in regulatory programs.
This position is accountable for the analysis, development, implementation, maintenance, and testing of software applications and/or programs as it relates to the ABCBS regulatory compliance systems. These activities include preparation of test data, program workflow creation, documentation and training. The incumbent is expected to make recommendations of workable solutions to compliance systems problems.
The Compliance Analyst - EDS is responsible for overseeing the development and maintenance of the Regulatory compliance program systems and the development and maintenance of the compliance systems policies and processes consistent with government requirements and industry standards. He/she provides guidance, consultation, training, communications, audits, and issues recommendations related to compliance system management. This professional maintains and uses current, working knowledge of compliance standards applicable to the health insurance industry.

Nature & Scope
The Compliance Analyst - EDS reports to the Regulatory Compliance Officer (RCO).  The position performs the majority of his/her assigned tasks in a self-managed environment with direct input from the Regulatory Project Manager or senior member of the operational project team. The incumbent coordinates and works closely with management, supervisory, and operational team members of the various divisions throughout Blue Cross related to regulatory initiatives, as well as various external contractors and auditors. The incumbent also works with CMS personnel, CMS-sponsored auditors, and compliance personnel from other plans. The incumbent works closely with team members, exhibiting responsibility, motivation, and persistence.
The incumbent works closely with members of the operational areas, systems and user business analysts, data warehouse staff, other enterprise wide technical staff, as well as the internal and external users to ensure user/customer requests, problems, and questions are researched and resolved in a timely manner. An individual in this position is able to formulate logical statements of business problems and devise effective solutions to these problems through the use of proposed manual procedures, an existing automated system or a proposed automated system. Assignments include analysis, data gathering, program workflow development, testing, documentation, training, and various other tasks as requested.
The incumbent maintains and uses current, working knowledge of compliance regulations, requirements, techniques, trends, tools, and advanced software/hardware compliance packages/devices applicable to the health insurance industry. This includes ongoing reading, learning, research, and may include periodic travel to various compliance seminars.
The Compliance Analyst - EDS promotes the integrity of compliance systems through enhancements to program software and processes. The incumbent will monitor the risk self-assessment on a regular basis to ensure that system safeguards and policies, procedures, or controls necessary to address gaps or deficiencies identified in audits and other measurement mechanisms are in place.

Skills, Knowledge and Abilities

• Strong motivation, and analytical, interpersonal, and problem solving skills. Must be able to work in self-managed environment.
• Excellent written, verbal, and project management skills.
• Ability to analyze a problem and develop a solution.
• Ability to establish goals and objectives and plan methods to achieve these goals.
• Demonstrate stability of performance under pressure and/or opposition.
• Possess above average investigative skills.
• Possesses good technical skills in computer hardware, software and computer operations techniques and procedures.
• Possess effective organizational skills.
• Ability to make decisions based on facts, intuition and experience and assume responsibility for those decisions.


• Strong motivation, and analytical, interpersonal, and problem solving skills. Must be able to work in self-managed environment.
• Excellent written, verbal, and project management skills.
• Ability to analyze a problem and develop a solution.
• Ability to establish goals and objectives and plan methods to achieve these goals.
• Demonstrate stability of performance under pressure and/or opposition.
• Possess above average investigative skills.
• Possesses good technical skills in computer hardware, software and computer operations techniques and procedures.
• Possess effective organizational skills.
• Ability to make decisions based on facts, intuition and experience and assume responsibility for those decisions.

Minimum Job Requirements

 

  • 1. Bachelors Degree from an accredited college or university with an emphasis in system administration and a minimum of 3 years of prior experience in systems analysis, workflow design, and implementation.

Or a minimum of 5 years of prior team lead or higher level experience in systems program workflow design and analysis with emphasis in government systems and regulations.

  • 2. One (1) year minimum experience developing and conducting user training and documentation (provide examples of documentation).

3.     Skills and experience in planning and leading systems design and releases, to include creating and executing testing plans, pilots and overseeing the testing and implementation process.

4.     Working knowledge of regulatory operations and interfaces between and among operational and systems areas as well as third party entities (vendors).

5.     Experience responding to systems requests and audits to governmental entities.

6.     Experience providing user training.

Willing to travel. Incumbent will attend educational seminars in various parts of the country; incumbent may also travel to various vendor sites for ABCBS.


Security Requirements
This position is identified as level three (3). This position must ensure the security and confidentiality of records and information to prevent substantial harm, embarrassment, inconvenience, or unfairness to any individual on whom information is maintained. The integrity of information must be maintained as outlined in the company Administrative Manual.

Segregation of Duties
Segregation of duties will be used to ensure that errors or irregularities are prevented or detected on a timely basis by employees in the normal course of business. This position must adhere to the segregation of duties guidelines in the Administrative Manual.

PRINCIPAL ACTIVITIES OR ACCOUNTABILITIES (Essential Functions of Job)
1. Planning and coordinating the regulatory compliance systems program in conjunction with the RCO.
2. Working with operational areas to gather business requirements, develop solutions using the Compliance 360 software, design and implement workflows, creation and maintenance of systems to meet regulatory compliance objectives.
3. Administering the internal and government systems, including Compliance360, HPMS, ACCUMEN, MARX, and others as identified. Verifying, coordinating, documenting and reporting that necessary users have access and systems are working appropriately.
4. Serving as internal help desk and contact for Compliance360 and other government systems users.
5. Developing and presenting training on Compliance 360 and other government systems as needed.
6. Leading testing and implementation of updates to the Compliance360 program software.
7. Serving as the Employee Point of Contact (EPOC) for CMS.
8. Responsible for understanding and timely upload of required audit, reports, attestations, and other documentation required by CMS, both scheduled and ad hoc.
9. Working with RCO and others to develop new modules and workflows in Compliance 360 as needed.
10. Developing and maintaining Compliance360 User Guides to ensure current with releases and updates, as well as Compliance office and government  policies.
11. Reviewing and maintaining compliance with the CMS and Arkansas Blue Cross core Security Requirements for systems and reporting vulnerabilities to upper management.
12. Developing, documenting, maintaining, and reviewing system –related policies for Compliance 360 and each major government application and support system.
13. Overseeing the annual review and updates to the System Security Plans, Risk Assessments, and Business Continuity and Recovery Plan.
14. Monitoring and investigating compliance security related incidents, and reporting significant problems to business partner management and regulatory agencies through established protocols.
15. Coordinating and cooperating in all evaluations of vendor’s compliance program.
16. Providing information to the RCO in support of the budgeting for Compliance systems activities.
17. Ensuring that all appropriate managers and users of all compliance and government systems are aware of the level of physical security offered and access and user requirements.
18. Maintaining current, working knowledge of information techniques, trends, tools, and advanced software/hardware compliance packages including information related to Federal and State regulations, BCBSA requirements, and ABCBS initiatives through ongoing reading, learning, research, and seminars.
*******    END    *******
 


Job Search

Select a location:
Enter a keyword(s):
 
- OR -