VP of Compliance

All about us

You likely know us as an insurance company, but that’s just a portion of what we do. Hundreds of thousands of North Dakotans trust us to provide them with personalized service and unmatched access to care. It’s a mission we take seriously.

We also work with entities throughout the state to challenge the cost and complexity of health care in North Dakota. This uncompromising goal requires caring, innovative people who are ready and willing to help create a new level of health and well-being in North Dakota and beyond.

Work environment

This opportunity is eligible for an in-office work arrangement located out of our Fargo, ND office. 

This position is eligible for internal Blue Cross Blue Shield employees and external applications.

Pay information

Pay Level: B

FLSA Category: Exempt - Salaried

A day in the life

The VP of Compliance is responsible for building, implementing and maintaining the Compliance and Ethics program including Regulatory Affairs and Special Investigations Unit (SIU). This position demonstrates executive level thought leadership, business acumen, strategic development and operational planning to promote and ensure effectiveness of compliance programs with applicable laws, statutory requirements and contractual obligations. The VP of Compliance is also responsible for providing leadership and direction to the Compliance, Regulatory, and SIU departments. Reports to the Audit and Compliance Committee of the Board of Directors with administrative reporting relationship to the CEO.

Your responsibilities will include

• Directs, leads and oversees staff in accomplishing work objectives within the unit. Coaches, motivates, rewards and recognizes subordinates. Sets clear goals and objectives. Sets performance expectations and holds employees accountable for achieving results.
• Serves as Compliance Officer for the Company and functions as a subject matter expert in emerging industry trends to facilitate, support and guide compliance activities and behaviors while maintaining consistency with the mission, vision and values of the enterprise.
• Analyzes existing and proposed legislation, regulatory announcements and industry practices to develop and implement procedures to meet existing and upcoming requirements. On a continuous basis, ensures on-going compliance with legislation, regulations, and adopted industry practices.
• Establishes a compliance governance program to continually evaluate enterprise wide risk and mitigation plans related to regulatory requirements. Regularly reviews new product/program strategies to ensure the regulatory environment is considered and they are implemented in a compliant manner.
• Leads the Company’s efforts to respond to Regulatory audits and inquiries in collaboration with business units and the Legal Department. Fosters a trusting and collaborative relationship with regulatory entities while at the same time ensuring the Company’s interests are protected.
• Implements and maintains an effective compliance program that fosters a compliant and ethical culture and encourages and provides mechanisms for employees to report suspected wrongdoing without fear of retaliation. Implements and monitors policies and procedures, ensuring compliance with applicable legal and contractual requirements reducing overall risk for the enterprise. Ensures education and investigation/review are performed with appropriate resolution and corrective action.
• Identifies potential areas of compliance vulnerability and risk, advising executive/senior level management, and consulting with internal business units to develop strategies to align with complex regulatory and policy requirements. Oversees any resulting mitigation or remediation plan.
• Cultivates collaborative relationships internally and externally to advise on corporate-wide risk assessment processes and ensure overall compliance with medical policy, regulations, and legislation to reduce fraud, waste, and abuse within the industry.
• Oversees establishment and maintenance of policies, procedures and processes for the fraud, waste and abuse program. Oversees coordination with law enforcement regarding substantiated fraud cases referred for prosecution or administrative actions.
• Regularly reports to and advises senior management and the Board of Directors regarding the Compliance, Regulatory and SIU programs and related initiatives. Provides written and verbal reports regarding compliance risk assessments, compliance trainings, conflicts of interest, compliance investigations, and other information as applicable.

What you need to succeed

• A Master's Degree in  Finance, Legal, Compliance, Business or related.
• A law degree and experience in health insurance is a plus!
• 15 years of experience in Compliance, regulatory, legal or related.
• 8 years of staff leadership experience with the desire to grow and develop the team.
• Confident in communication skills with the ability to create, maintain and foster relationships with leadership and the team.
• Have a strong sense of ethics and integrity.

Equivalent combination of education, experience or training determined to be acceptable by Human Resources may be substituted, unless regulated by contract or program standards

Benefits and perks

• Wellness incentives including well-being lifestyle spending accounts, employee assistance program and employee discounts.
• Encouraged paid time off including paid holidays and flexible holidays to use as you wish.
• 16 hours of paid volunteer time with a $200 donation to a charity of your choice upon completion of all volunteer hours.
• Employee recognition, community initiative events and yearly company outings.
• Workplace flexibility offering different options for working arrangements and the freedom to make time for important commitments.
• Our core benefits include health, dental, vision and life insurance, short-term and long-term disability and paid parental leave.

Equal opportunity employment

Equal Opportunity Employer of Minorities, Females, Protected Veterans and Individual with Disabilities, as well as Sexual Orientation or Gender Identity.

For questions, please email careers@bcbsnd.com.

This job posting will be closed 2/20/2024 at 8:00 a.m. (CT). No further applications will be considered.