Jobs at Blue Cross Blue Shield Association

Leads corporate compliance, privacy, ethics, HIPAA, GDPR, and Medicare compliance programs. Serves as Compliance, Privacy, and Medicare Compliance Official; advises executives, the Board, and governance committees; oversees investigations, regulatory risk mitigation, training, incident response, and policy development. Manages a compliance and privacy team, drives organizational change, ensures CMS and government-program compliance, and safeguards patient and organizational data.

Leads strategic consulting projects, conducts primary and secondary research, analyzes data, develops actionable recommendations, and presents executive deliverables to senior leadership. Supports strategic planning and BCBS Plan engagement, manages project work plans, collaborates with business partners, and coaches junior staff. Requires strong analytical problem-solving, communication, facilitation, relationship-building, and project leadership skills, with familiarity with the health insurance industry. AI literacy and generative AI experience are preferred.

Partners with product, engineering, design, and business teams to translate requirements into user stories, analyze customer and product data, build dashboards, track KPIs, and inform roadmap priorities. Conducts market and competitive research, defines acceptance criteria, identifies product opportunities, and recommends evidence-based improvements. The role also supports client-facing activities, product governance, documentation, audit readiness, and compliance with SOC 2, HIPAA, and secure data-handling standards.

Provides executive leadership for Federal Employee Program products across medical, dental, vision, postal, and overseas offerings. Owns portfolio strategy, pricing collaboration, product development, marketing, brand positioning, member engagement, and growth initiatives. Leads product launches, market analysis, benefit changes, partnerships, and member experience improvements. Manages and develops a high-performing team while coordinating with actuarial, clinical operations, plans, and strategic partners to achieve enrollment, profitability, quality, and retention goals.

Leads the financial and operational internal audit plan, directing concurrent audits, supervising audit staff, reviewing audit quality and findings, and advising senior management. Oversees risk assessments, internal controls, audit reporting, strategic improvement initiatives, and quality programs. Evaluates and deploys AI-enabled audit tools, prepares executive and committee presentations, manages audit issues, and coordinates with enterprise risk, compliance, and information security functions.

Lead Accreditation and Quality operations for FEP, set strategy for QCR measures, ensure compliance with HEDIS/NCQA/URAC, manage cross-functional accreditation projects, develop programs to improve member care, oversee budgets, and lead a department to meet Plan and accreditor requirements.