Network Compliance Manager, Principal

Blue Cross and Blue Shield Association

Lodi, CA
10 days ago

Highlights

You will help lead critical regulatory initiatives, including block transfers, provider termination transition planning, member notification processes, and required state filings, while exercising judgment to resolve complex compliance issues. In this role you will serve as the primary liaison with state regulators and plan partners, ensuring strong regulatory relationships while overseeing compliance with evolving state requirements across Commercial, Medicare Advantage, and Medi-Cal lines of business.

Numbers & Facts

Location	Lodi, CA
Industry	Insurance
Company Size	2,000 to 2,499 employees
Website	https://www.bcbs.com/about-us/careers

Description

Your Role

The Network Compliance team collaborates to ensure regulatory compliance with regulations pertaining to HMO, PPO, Medicare, and Medi-Cal provider network disruptions. The Network Compliance Manager, Principal, will report to the Sr. Manager of Network Operations. In this role you will serve as the primary liaison with state regulators and plan partners, ensuring strong regulatory relationships while overseeing compliance with evolving state requirements across Commercial, Medicare Advantage, and Medi-Cal lines of business. You will help lead critical regulatory initiatives, including block transfers, provider termination transition planning, member notification processes, and required state filings, while exercising judgment to resolve complex compliance issues.

Our leadership model is about developing great leaders at all levels and creating opportunities for our people to grow - personally, professionally, and financially. We are looking for leaders that are energized by creative and critical thinking, building and sustaining high-performing teams, getting results the right way, and fostering continuous learning.

About Company

At the Blue Cross and Blue Shield Association (BCBSA), we provide business strategy, technical support and consulting expertise to 36 Blue Cross and Blue Shield companies across the nation, employing more than 1,000 of the best strategic thinkers in the industry. We are a Brand manager that sets quality control standards for the 36 independent companies that use the Blue Cross and Blue Shield Brands, and we serve as a trade association that represents these Blue companies. It is through our involvement that the Blues companies share a united vision and strategy while also benefiting from the local strength of all member companies.