Experienced Director Regulatory Compliance with a demonstrated history of working in the hospital & health care industry. Skilled in Medicare Advantage, Legal Compliance, Compliance Program Management, Healthcare Industry, and Compliance Management. Strong legal professional with a Master of Public Administration (MPA) focused in Healthcare Services from University of Utah.
Since 1945, we’ve taken our role as an Idaho-based health insurance company to heart. While the health insurance marketplace has experienced lots of change in recent years, our mission has remained the same. We’re driven to help connect Idahoans to quality healthcare that is affordable and build strong networks and services with our members in mind. Blue Cross of Idaho is a leader in the health insurance industry- addressing healthcare costs and delivering exceptional customer experiences through innovative tools and services. We are dedicated to attracting and developing leaders who share our vision of transforming the healthcare experience of the communities we serve in Idaho and beyond.
AI data controls; AI innovations/controls; compliance incident process mgmt; regulatory implementation timeliness; "Better at the Basics"; Mental Health Parity; Risk Adjustment
Carelon Rx; Snowflake; Cognizant; JIVA; Workday; SalesForce; Microsoft; E-source; Zoom;
20
N/A
600000
Kevin Tighe, Chief Audit Executive
$150 to $300 million
MedAdvantage profitability (STARS and Risk Adjustment); AI capabilities ( risk and innovation); "Better at the Basics" - evaluating core processes; compliance risk assessment
For Compliance work, I am most interested in hearing from LogicGate, Ethiko, AuditBoard, Inovaare, Healthicity, Wolters Kluwers, G2
12-24 months
N/A