Risk Adjustment Compliance, Sr. Principal

Your Role

The Risk Adjustment Compliance team plays a critical role in ensuring that Blue Shield maintains appropriate adherence to federal and state regulations. The Director, Risk Adjustment Compliance will report to the Senior Director, Government Programs Compliance. In this role you will provide strategic leadership and management of the department overseeing compliance with regulations and laws related to Risk Adjustment across our Marketplace (ACA), Medicaid and Medicare lines of business, which includes implementation of elements of an effective compliance program. You will oversee the development of risk assessments oversight and the monitoring of work plans pertaining to Risk Adjustment and partner with business areas to ensure and implement effective prevention, detection and correction of compliance issues.