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Regulatory Compliance Specialist

Premera Blue Cross

Senior Regulatory Compliance & Ethics Program AdministratorJoin Our Team: Do Meaningful Work and Improve People's LivesOur purpose, to improve customers' lives by making healthcare work better, is far from ordinary. And so are our employees. Working at Premera means you have the opportunity to drive real change by transforming healthcare.To better serve our customers, we are fostering a culture that emphasizes employee growth, collaborative innovation, and inspired leadership. We are dedicated to creating an environment where employees can excel and where top talent is attracted, retained, and thrives. As a testament to these efforts, Premera has been recognized on the 2025 America's Dream Employers list. Newsweek honored Premera as one of America's Greatest Workplaces, America's Greatest Workplaces for Inclusion, and America's Greatest Workplaces For Mental Well-Being, and Forbes ranked Premera among America's Best Midsize Employers for the fourth time.For Premera, Regulatory Compliance is not just a control function, but also an enabling one. Our members expect that their healthcare benefits provide access to high-quality, cost-effective care that complies with all applicable regulations. Regulatory Compliance works closely with our internal teams to ensure that our offerings can meet the diverse needs of multiple stakeholders.The Senior Regulatory Compliance & Ethics (RC&E) Program Administrator takes a lead role in the development, implementation, oversight and monitoring of Premera Blue Cross's Compliance & Ethics Program. In this dynamic role, the Senior RC&E Administrator is an advocate on behalf of Premera with external stakeholders to support our corporate goals, and partners with Legislative Affairs and Legal to guide internal Premera teams on the implementation of new and changing laws and regulations.What You'll Do:Assess, analyze, and track regulatory agency activities and work with the business to develop the Company's advocacy position in response. Advise the business on the implications, serving as the subject matter expert regarding defined regulatory and compliance matters. Formulate and carry out strategies to lobby for Premera's interests and in furtherance of Premera's long term goals with regulators, government entities, private entities, and interest groups. Assist the business and third parties with the implementation of new and changing laws and regulations.Plan and conduct large, complex and/or multi-functional compliance monitoring reviews to verify compliance with established policies and applicable regulations. Conduct reviews of business processes to ensure compliance with relevant laws and regulations.Manage inquiries and exams from state and federal regulators. Develop and mature relationships with regulators to serve as the "face" of Premera.Act as an internal consultant to identify key regulatory and compliance issues and recommend informed, actionable and realistic solutions based on regulatory/policy/compliance research. Where needed prepare written reports to document findings and issue Corrective Action Plans, tracking them through to resolution.Effectively interact with all levels of management, altering communication style where needed to ensure comprehension; possess extensive understanding of cross-organizational operations to provide thorough, accurate and timely analysis of regulatory and compliance questions in an easy-to-understand format.Take a lead role on the company's Advocacy Committee and, in that capacity, distribute and collect comments, and draft consolidated responses to regulatory agencies concerning proposed regulations from Committee members, business owners, and other subject matter experts.Take a lead role to support the Compliance & Ethics Committee to push compliance and ethics initiatives through to completion.Serve as the regulatory and/or compliance expert and strategic thinking partner on cross-departmental workgroups; build relationships across the company to ensure visibility of regulatory and compliance impacts and issues and increase trust in RCE as a partner for proactive problem-solving.Develop ongoing education, tools and resources for all levels of management and employees to allow for self-service research where requirements are straightforward. Create tools and other educational documents to help explain complex topics. Advise and collaborate with employees at all levels to promote a culture of ethical behavior and compliance.Evaluate and provide recommendations to leaders across the company for process improvements based on observations of trends, issues and obstacles. Continuously improve Regulatory Compliance & Ethics processes by using LEAN methodologies to streamline work and eliminate low value activities.As assigned, take an ownership role over compliance related tasks such as OFAC/Sanction Checks, hotline investigations, regulatory reporting and filing, policy and procedure maintenance, conflict of interest research, compliance and regulatory report compilation, etc. Ensure all assigned tasks are performed thoroughly, accurately and by department due dates.Mentor other Regulatory Compliance & Ethics personnel as assigned.Proactively anticipate the impact of the changing business environment and adjust processes as necessary.Perform other duties as assigned.What You'll Bring:Bachelor's degree or four (4) years' work experience. (Required)Six (6) years' experience working in the regulatory, compliance, legal, public policy, or internal audit space or post graduate education in a related field and experience. (Required)Willingness and ability to obtain Certified Compliance & Ethics Professional designation within one year of hire. (required)Certified Compliance and Ethics Professional (CCEP) (Preferred)Juris Doctorate (JD) (Preferred)Prior healthcare or insurance background (Preferred)Advanced degree in a related field (Preferred)Prior experience advocating directly with regulatory agencies at the state/federal level (Preferred)Effective interpersonal, written and presentation skills with ability to research and communicate complex, technical information in an accurate and easily understandable manner to all levels of employees, including leadership.Knowledge of Washington, Alaska and federal health plan laws, including the Affordable Care Act.Proven ability to effectively collaborate with stakeholders both internally and externally to independently represent Premera's interests and/or demonstrated experience monitoring regulatory environments focusing on compliance requirements.Exceptional ability to analyze and evaluate complex legal and regulatory requirements while also being able to act as a consultant to the business.Demonstrated expert analytical skills; proven ability to identify and question information that goes outside the norm and to identify the root cause behind findings to assist management in the development of effective corrective action plan.Demonstrated ability to efficiently and effectively handle and prioritize multiple complex assignments often involving multiple functional areas and vendors while ensuring high quality outcome in all work products.Strong motivation to learn, willingness to be a team player, yet operate independently as required.Proven ability to review the work of others and give constructive and effective feedback and coaching to improve performance.Working Environment:Work is performed within a normal office environment with ambient temperature.Physical Requirements:The following have been identified as essential physical requirements of this job and must be performed with or without an accommodation:This is primarily a sedentary role which requires the ability to exert up to 10 lbs. of force occasionally and/or a negligible amount of force frequently or constantly to lift, carry, push, pull, or otherwise move objects, including the human body.This role requires the ability to keyboard and to communicate clearly and understandably in person and over the telephone.Premera Total Rewards:Our comprehensive total rewards package provides support, resources, and opportunities to help employees thrive and grow. Our total rewards are more than a collection of perks, they're a reflection of our commitment to your health and well-being. We offer a broad array of rewards including physical, financial, emotional, and community benefits, including:Medical, vision, and dental coverage with low employee premiums.Voluntary benefit offerings, including pet insurance for paw parents.Life and disability insurance.Retirement programs, including a 401K employer match and a pension plan that is vested after 3 years of service.Wellness incentives with a wide range of mental well-being resources for you and your dependents, including counseling services, stress management programs, and mindfulness programs, just to name a few.Generous paid time off to reenergize.Looking for continuing education? We have tuition assistance for both undergraduate and graduate degrees.Employee recognition program to celebrate anniversaries, team accomplishments, and more.For our hybrid employees, our on-campus model provides flexibility to create your own routine with access to on-site resources, networking opportunities, and team engagement.Commuter perks make your trip to work less impactful on

Vacancy posted 3 days ago
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