Association Affairs Consultant II, Remote

Job description

Job Summary: This role will provide critical support to GuideWell's Inter-Plan Executive Office with a dedicated focus on Blue Cross Blue Shield Association/Inter-Plan Programs Compliance and Executive Escalations. The initial immediate focus and primary accountability of the critical role will be on facilitating resolution of BCBSA Inter-Plan Executive Escalations. The work scope includes escalations for all GuideWell-owned Blue Branded entities (e.g., Florida Blue, Triple-S, Florida Health Care Plan, Capital Health Plan) and non-Blue branded entities who perform Blue functions on GuideWell’s behalf (e.g., WebTPA). Escalations can be outgoing (GuideWell-escalated), or incoming (escalated from another Blue Plan or the BCBSA). Essential Functions: Identify risks, evaluate controls and prepare findings and recommendations. Implement compliance programs to prevent illegal, unethical or improper business practices. Perform audits to ensure the organization’s programs are consistently administered in compliance with organizational policies and procedures, contractual obligations, rulings, laws and government regulations. Monitor and evaluate the effectiveness of solutions, policies, pra...