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Compliance Monitoring Specialist

Sapphire Digital

Sapphire Digital

Legal
St. Petersburg, FL, USA
Posted on Friday, September 8, 2023

The Compliance Monitoring Specialist will support the Compliance Monitoring Manager with planning and executing of monitoring and testing engagements to validate the efficacy of regulatory and contractual compliance internal controls. Assists with the development of the Compliance Monitoring Program, including policies and procedures. Coordinates with cross-functional teams to assess compliance risks, establish monitoring protocols, and identify areas for improvement.

Responsibilities:

  • Monitor and test ongoing activities of the Business Units to ensure compliance with regulatory and contractual requirements and business policies and procedures
  • Assist in developing, implementing and maintaining the testing and monitoring examination and risk assessment programs
  • Collaborate with relevant stakeholders to assess and analyze compliance risks, emerging trends, and regulatory changes that impact the Business Units
  • Work with the Business Units to enhance and implement controls to address deficiencies
  • Perform compliance testing and reviews to evaluate the effectiveness of controls, identify non-compliance issues, and recommend corrective actions
  • Help develop and recommend policies, procedures and programs to ensure compliance with existing regulations and best practices

Skills:

  • Highly motivated, self directed, proactive, self-disciplined and team-oriented
  • Ability to embrace complexity
  • Ability to develop standards for maintaining regulatory and contractual compliance
  • Organization, project management, and strategic planning skills
  • Demonstrated accountability and keen ability to meet aggressive time frames
  • High degree of professional ethics and integrity
  • Sound judgment and ability to analyze situations and information
  • Excellent verbal communication and documentation skills
  • Attention to detail
  • Understanding of regulatory frameworks
  • Maintain a professional demeanor and confidentiality in sensitive situations
  • Recognized as a collaborative business partner with various departments throughout the organization

Qualifications:

  • BA or BS in business management, or similar field
  • 3-5 years of related experience in developing and implementing monitoring and testing procedures or other relevant substantive experience
  • Experience in the healthcare industry and/or compliance with a level of understanding and knowledge of industry practices
  • Knowledge of compliance regulations and compliance monitoring techniques

Travel Less than 20%

#LI-GC1

As a leading payments company in healthcare, we guide, price, explain, and pay for care on behalf of insurers and their members. We’re Zelis in our pursuit to align the interests of payers, providers, and consumers to deliver a better financial experience and more affordable, transparent care for all. We partner with more than 700 payers, including the top-5 national health plans, BCBS insurers, regional health plans, TPAs and self-insured employers, over 4 million providers, and 100 million members, enabling the healthcare industry to pay for care, with care. Zelis brings adaptive technology, a deeply ingrained service culture, and a comprehensive navigation through adjudication and payment platform to manage the complete payment process.

Commitment to Diversity, Equity, Inclusion, and Belonging
At Zelis, we champion diversity, equity, inclusion, and belonging in all aspects of our operations. We embrace the power of diversity and create an environment where people can bring their authentic and best selves to work. We know that a sense of belonging is key not only to your success at Zelis, but also to your ability to bring your best each day.

Equal Employment Opportunity
Zelis is proud to be an equal opportunity employer. All applicants will receive consideration for employment without regard to race, color, religion, age, sex, national origin, disability status, genetics, protected veteran status, sexual orientation, gender identity or expression, or any other characteristic protected by federal, state or local laws.

We encourage members of traditionally underrepresented communities to apply, even if you do not believe you 100% fit the qualifications of the position, including women, LGBTQIA people, people of color, and people with disabilities.

Accessibility Support

We are dedicated to ensuring our application process is accessible to all candidates. If you are a qualified individual with a disability or a disabled veteran and require a reasonable accommodation with any part of the application and/or interview process, please email TalentAcquisition@zelis.com

SCAM ALERT: There is an active nationwide employment scam which is now using Zelis to garner personal information or financial scams. This site is secure, and any applications made here are with our legitimate partner. If you’re contacted by a Zelis Recruiter, please ensure whomever is contacting you truly represents Zelis Healthcare. We will never asked for the exchange of any money or credit card details during the recruitment process. Please be aware of any suspicious email activity from people who could be pretending to be recruiters or senior professionals at Zelis.