Blue Cross Rn Remote Jobs in Des Moines, IA (NOW HIRING)

We are hiring a Compliance Business Partner to join our team at UnityPoint Health! This role serves as a key member of the Corporate Compliance Program, responsible for leading and executing compliance investigations across the health system, including those involving clinical care, regulatory requirements, and professional standards. The Business Partner will partner closely with operational leaders, clinical leadership, legal counsel, human resources, and risk management to assess concerns, ensure objective fact-finding, and support timely resolution consistent with regulatory requirements and organizational expectations. The position plays a critical role in maintaining an effective compliance program by promoting accountability, identifying systemic risks, and supporting continuous improvement. 

RN's with clinical auditing and/or emergency department experience are highly encouraged to apply! 

Location: Remote - applicants must reside within the UnityPoint Health footprint of Iowa, Illinois, or Wisconsin. Some travel required.  

Hours: Monday-Friday, standard business hours 

At UnityPoint Health, you matter. We’re proud to be recognized as a Top 150 Place to Work in Healthcare by Becker's Healthcare several years in a row for our commitment to our team members.  

Our competitive Total Rewards program offers benefits options that align with your needs and priorities, no matter what life stage you’re in. Here are just a few:   

• Expect paid time off, parental leave, 401K matching and an employee recognition program.   

• Dental and health insurance, paid holidays, short and long-term disability and more. We even offer pet insurance for your four-legged family members.  

• Early access to earned wages with Daily Pay, tuition reimbursement to help further your career and adoption assistance to help you grow your family.   

With a collective goal to champion a culture of belonging where everyone feels valued and respected, we honor the ways people are unique and embrace what brings us together.  

And, we believe equipping you with support and development opportunities is a vital part of delivering an exceptional employment experience. 

Find a fulfilling career and make a difference with UnityPoint Health.

Lead Compliance Investigations: 

• Lead and manage end-to-end compliance investigations. 
• Investigation Process:
  • Develop investigation plans, define scope, and execute timely, objective, and well-documented reviews 
  • Coordinate with key stakeholders and resources for the investigation 
  • Document all key steps in the investigation process; responsible for the maintenance of all key investigation documentation 
  • Identify and ensure required notifications to regulatory bodies are completed by appropriate leader, e.g., Pharmacist in Charge to the Drug Enforcement Agency, Chief Nursing Officer to the Iowa Board of Nursing 
  • Identify best practices for processes and documentation. 
  • Analyze findings to determine root cause, regulatory implications, and risk exposure 
  • Prepare clear, defensible investigation reports suitable for executive leadership and legal review 
  • Serve as a point of contact for all Markets 
• Coordinate and/or establish a plan of correction if compliance issues are identified. 
• Plan of Correction
  • Create and implement appropriate plan of correction with key stakeholders
  • Monitor action plan status to completion 
  • Escalate any documentation or action plan concerns to leader  
• Create, coordinate, and deliver required action and training as applicable
  • Assess need for systemwide training based on investigation findings 
  • Ensure updates to annual training, as applicable 
• Conduct internal Auditing/Monitoring for compliance issues
• Proactive Auditing/Monitoring 
  • Establish and periodically review key metrics 
  • Collaborate with key stakeholders including, but not limited to, Human Resources, Risk Management, Pharmacy, Nursing, and Legal 
  • Review various audits of key data   
• Stay updated on regulatory and policy changes impacting UnityPoint Health 
• Consult and coach leaders to guide them through their responsibilities, including reporting, in high-risk issues 

Compliance Acumen:

• Maintain a deep understanding of compliance, direction, challenges and needs
• Leverage the knowledge to support and guide business solutions that achieve desired outcomes
• Build an understanding of the external compliance trends and strategy 
• Participate in compliance and business strategies to drive key initiatives and results 
• Partner with leaders during investigations to ensure they are using compliance tools and resources to help front line leaders and team members improve and support compliance guidelines 
• Understands, follows and ensures compliance with relevant laws, regulations and organizational policies and provides guidance accordingly

Relationship Management:

• Act as a trusted advisor and point of contact for any regulatory or governance queries by providing guidance
• Promote an open line of communication between compliance and business to ensure updates on current compliance investigations are known 
• Leverage one compliance team mindset in collaborating across the business to deliver a global, unified experience for the business

Education:

• Required: Bachelor’s degree in nursing or healthcare related field

Experience: 

• Required: 5 years of experience in nursing or other clinical experience
• Required: 5 years of experience in compliance, investigations, auditing, monitoring, data collection, analysis, trending, and reporting<