JOB DESCRIPTION
Your Role

The Mandates Control Group (MCG) team is responsible for analyzing new laws and regulations, identifying the implications, and affected business areas, including business subject matter experts, preparing a work order for the project management team and/or the business to execute, and confirming completion from the Business Owner/Business Driver(s) once implementation is final. The MCG Specialist, Consultant will report to the Senior Manager, Mandates Control Group. In this role, you will be responsible for analyzing new laws and regulations, identifying impacted business areas, creating a work order, and confirming completion.

Your Work

In this role, you will:

• Drive and manage identification and scoping of impacts across cross-functional business areas due to newly enacted or revised mandates: state and federal legislation; Blue Cross Blue Shield Association rules; and Covered California contractual requirements
• Work collaboratively and advise diverse business areas across the enterprise on the development of mandate solutions for newly enacted or revised mandates
• Document impacted business units and stakeholders, business impact statements, identified risks and mitigation plans in a controlled document
• Confirm successful implementation of solutions to meet mandate requirements from Business Owner and Business Driver(s), emphasizing business accountability for on-going compliance
• Develop, prepare and present low to medium complexity analyses, reports and recommendations to MCG Management
• Escalate and propose resolution for low to moderately complex mandate and process issues
• Advocate for 100% mandates compliance, where non-compliance is non-negotiable, and mandates compliance is achieved and sustained
• Advance a culture of business accountability and solve for gaps in business accountability for mandates compliance

QUALIFICATIONS
Your Knowledge and Experience

• Requires a bachelor’s degree or equivalent experience
• Requires at least 7 years of prior relevant experience
• Requires understanding of health insurance operations, healthcare compliance, mandates, regulations, and legislative requirements with expertise in Covered CA or Qualified Health Plans (QHP) preferred
• Requires advanced interpersonal, oral and written communication skills, including ability to effectively manage up to leaders at all levels
• Requires excellent analytical and problem-solving skills
• Must be self-motivated, creative, detail-oriented, and proactive with the ability to work independently and with limited direction
• Must be comfortable in a culture of accountability
  

Pay Range:

The pay range for this role is: $ 109120.00 to $ 163680.00 for California.

Note:

Please note that this range represents the pay range for this and many other positions at Blue Shield that fall into this pay grade. Blue Shield salaries are based on a variety of factors, including the candidate's experience, location (California, Bay area, or outside California), and current employee salaries for similar roles.

ABOUT THE TEAM
Blue Shield of California’s mission is to ensure all Californians have access to high-quality health care at a sustainably affordable price. We are transforming health care in a way that truly serves our nonprofit mission by lowering costs, improving quality, and enhancing the member and physician experience.

To fulfill our mission, we must ensure a diverse, equitable, and inclusive environment where all employees can be their authentic selves and fully contribute to meet the needs of the multifaceted communities we serve. Our comprehensive approach to diversity, equity, and inclusion combines a focus on our people, processes, and systems with a deep commitment to promoting social justice and health equity through our products, business practices, and presence as a corporate citizen.

Blue Shield has received awards and recognition for being a certified Great Place to Work, best place to work for LGBTQ equality, leading disability employer, one of the best companies for women to advance, Bay Area’s top companies in volunteering & giving, and one of the world’s most ethical companies. Here at Blue Shield of California, we are striving to make a positive change across our industry and the communities we live in – join us!

Our Values:

• Honest . We hold ourselves to the highest ethical and integrity standards. We build trust by doing what we say we're going to do and by acknowledging and correcting where we fall short.
• Human . We strive to be our authentic selves, listening and communicating effectively, and showing empathy towards others by walking in their shoes.
• Courageous . We stand up for what we believe in and are committed to the hard work necessary to achieve our ambitious goals.

From the earliest days of the pandemic, Blue Shield of California has been unyielding in our commitment to putting the health and safety of our people, our members and our communities first. As a health care company, Blue Shield requires all employees to be up to date with COVID-19 vaccination prior to start date as a condition of employment. Blue Shield will consider requests for medical or religious accommodation to this vaccination requirement prior to your start date.

The definition of "up to date with your COVID-19 vaccine" is when you have received all doses in the primary series and one booster when eligible. If you are unable to be up to date with your COVID-19 vaccine by your start date, your start date will need to be postponed and you will have 30 days to remedy. If you cannot fulfill the requirement nor obtain an accommodation within 30 days, your offer will be rescinded.