Top 17 Licensing specialist Jobs in San Francisco Ca

Government Programs Compliance Specialist, Senior
Blue Shield of California —Oakland, CA
- $90,860 - $136,290 a year
- Full-time
- Hybrid work
- Background check
- Microsoft Excel
- Microsoft Outlook
- Health insurance
- Work from home
9d
Risk Adjustment Compliance Specialist, Principal
Blue Shield of California —Oakland, CA
- $148,940 - $223,300 a year
- Full-time
- Hybrid work
- Background check
- Pass drug screening
- Office
- Work from home
7d
Credentialing and Licensing Specialist III
Millennium Healthcare Management Serv LLC —San Francisco, CA
- $22.99 - $34.49 an hour
- Full-time
- Research
- Mid-level
- 3 years
Quick Apply
2d
Safety and Compliance Specialist
Droyd —San Francisco, CA
- $120,000 - $170,000 a year
- Full-time
- Mid-level
Compliance & Outcomes Specialist
Hike Medical —San Francisco, CA
- $140,000 - $200,000 a year
- Full-time
- Hybrid work
- Mid-level
- Office
- Commercial
Compliance Operations Specialist
Flynn Group —San Francisco, CA
- Monday to Friday
- Hybrid work
- Mid-level
- Office
- Analysis skills
- Disability insurance
- Health insurance
Quick Apply
Compliance Specialist, SF
Abode Services —San Francisco, CA
- $26 - $28 an hour
- Mid-level
- High school diploma or GED
- Bachelor's degree
- Dental insurance
- Flexible spending account
Quick Apply
Compliance Specialist - San Francisco Corporate Office
The John Stewart Company —San Francisco, CA
- $38.50 - $43.25 an hour
- Full-time
- Microsoft Excel
- Microsoft Outlook
- Sales
- Commuter assistance
- AD&D insurance
Technical Compliance Specialist
Lytton Tribal Gaming Commission —San Pablo, CA
- Overtime
- Background check
- English
- Research
- Health insurance
- Dental insurance
Quick Apply
3d
Privacy & Compliance Specialist
Superpower —San Francisco, CA
- Full-time
- 5 years
- HIPAA
- Research
Sr. Compliance Specialist (Regulated Industry)
Mentor Technical Group —Redwood City, CA
- Full-time
- Senior level
Housing Compliance Specialist - Full Time - 40 Hours/Week (PM5)
Episcopal Community Services —San Francisco, CA
- $35.31 - $36.90 an hour
- Full-time
- Current TB test
- Mid-level
- Organizational skills
- Health insurance
Quick Apply
Compliance Specialist
Apartment Management Consultants, LLC —San Leandro, CA
- $22 - $24 an hour
- Full-time
- Pass drug screening
- Mid-level
- Travel
- Paid holidays
- Disability insurance
Quick Apply
Qualified SWPPP Developer (QSD) / Senior Environmental Compliance Specialist
BKF —Walnut Creek, CA
- $100,000 - $145,000 a year
- Full-time
- Hybrid work
- Construction site
- Office
- 8 years
- Profit sharing
- Paid holidays
Quick Apply

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Risk Adjustment Compliance Specialist, Principal
Blue Shield of California —Oakland, CA
A degree in health care administration, business, public health, or related field is highly preferred. Participates in the identification and assessment of…
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Government Programs Compliance Specialist, Senior

Blue Shield of California -
Oakland, CA

Apply Now

Job Details

Full-time
$90,860 - $136,290 a year
9 days ago

Benefits

Health insurance
Work from home

Qualifications

Microsoft Excel
Microsoft Outlook
Medicare
Professional ethics
CMS
CMS regulatory compliance
Health insurance knowledge
Medicare regulations
SharePoint
Medicaid regulations
Cross-functional collaboration

Full Job Description

Your Role

The Medicare Compliance team is responsible for providing oversight of Blue Shield’s Medicare Advantage and Part D plan operations to help ensure compliance with CMS regulations, contractual requirements, and internal policies. The Government Programs Compliance Specialist, Senior will report to the Senior Manager, Government Programs – Medicare Compliance. In this role, you will help support the effectiveness of the Medicare Compliance Program through risk-based monitoring, audits, and compliance activities that include evaluating the accuracy, completeness and integrity of plan materials, identifying compliance risks, and partnering with business teams to promote regulatory compliance and corrective action.

Your Work

In this role, you will:

Perform regulatory compliance reviews of Medicare Advantage and Part D plan member and marketing materials and (as required) submit materials to the Centers for Medicare and Medicaid Services (CMS) and the Department of Health Care Services (DHCS).
Document final compliance solutions, identified risks, and mitigation plans in a controlled document.
Monitor implementation of corrective action plans to ensure remediation activities are on track, risks are identified, and mitigation plans are developed; escalate issues to department management as appropriate.
Summarize and distribute low to complex federal and state updates to impacted business areas.
Provide day-to-day support to business areas that support Blue Shield’s Medicare Advantage and Part D plans on low to moderately complex inquiries.
Manage and maintain Medicare Compliance department activities e.g. development and maintenance of the department audit calendar, CMS, DMHC and DHCS audit calendar, department mailboxes, intranet website, policies and procedures, and other items as needed.
Support calibration of risk and controls with business units supporting the Medicare line of business.
Develop, prepare, and present analyses, reports, and recommendations to department management and other stakeholders of federal and state requirements
Participate in multiple projects or initiatives within and outside of the department.
Other duties as assigned.

Your Knowledge and Experience

Requires a bachelor’s degree or equivalent experience
Requires a minimum of 5 years of relevant experience conducting compliance reviews of Medicare Advantage and Part D plan marketing and member communication materials
Requires a deep knowledge of the Centers for Medicare & Medicaid Services’ (CMS) compliance requirements for Medicare Advantage and Part D plan member and marketing materials, as well as the Department of Health Care Services’ (DHCS) compliance requirements for exclusively aligned enrollment dual special needs plan member and marketing materials.
Requires excellent organizational skills.
Requires strong independent judgment, problem solving, critical and analytical skills, including an exceptional “moral compass” and work ethic.
Requires ability to work collaboratively in a team, perform duties with minimal supervision, multi-task, and to deliver a quality product in a highly regulated, demanding, and constantly changing corporate environment.
Requires proficiency in Microsoft Office suite programs (Word, Access, Excel, PowerPoint and Outlook), SharePoint, and the Health Plan Management System (HPMS).
Project management or similar experience is preferred
Professional certification (CHC – Certification in Healthcare Compliance) is preferred

Hybrid

This role requires employees to be in-office based on our hybrid workplace model, balancing purposeful in-person collaboration with flexibility. For most teams, this means coming into the office two days each week.

Employees living more than 50 miles from an office location will work with their manager to determine in-office time based on business need.

ABOUT THE TEAM
About Blue Shield of California

As of January 2025, Blue Shield of California became a subsidiary of Ascendiun. Ascendiun is a nonprofit corporate entity that is the parent to a family of organizations including Blue Shield of California and its subsidiary, Blue Shield of California Promise Health Plan; Altais, a clinical services company; and Stellarus, a company designed to scale healthcare solutions. Together, these organizations are referred to as the Ascendiun Family of Companies.

At Blue Shield of California, our mission is to create a healthcare system worthy of our family and friends and sustainably affordable. We are transforming health care in a way that genuinely serves our nonprofit mission by lowering costs, improving quality, and enhancing the member and physician experience.

To achieve our mission, we foster an environment where all employees can thrive and contribute fully to address the needs of the various communities we serve. We are committed to creating and maintaining a supportive workplace that upholds our values and advances our goals.

Blue Shield is a U.S. News Best Company to work for, a Deloitte U.S. Best Managed Company and a Top 100 Inspiring Workplace. We were recognized by Fair360 as a Top Regional Company, and one of the 50 most community-minded companies in the United States by Points of Light. Here at Blue Shield, we strive to make a positive change across our industry and communities – join us!

Our Values:

Honest. We hold ourselves to the highest ethical and integrity standards. We build trust by doing what we say we're going to do and by acknowledging and correcting where we fall short.
Human. We strive to listen and communicate effectively, showing empathy by understanding others' perspectives.
Courageous. We stand up for what we believe in and are committed to the hard work necessary to achieve our ambitious goals.

Our Workplace Model

We believe in fostering a workplace environment that balances purposeful in-person collaboration with flexibility - providing clear expectations while respecting the diverse needs of our workforce. Our workplace model is designed around intentional in-person interaction, collaboration, connection, creativity and flexibility:

For most teams, this means coming into the office two days per week.
Employees living more than 50 miles from an office location, out of state employees, and employees in certain member-facing roles should work with their manager to determine in-office time based on business need.
For employees with medical conditions that may impact their ability to work in-office, we are committed to engaging in an interactive process and providing reasonable accommodations to ensure their work environment is conducive to their success and well-being.

The Company reserves the right to require more presence in the office based on business needs, and requirements are subject to change with periodic reviews.

Physical Requirements:

Office Environment - roles involving part to full time schedule in Office Environment. Based in our physical offices and work from home office/deskwork - Activity level: Sedentary, frequency most of work day.

Equal Employment Opportunity:

External hires must pass a background check/drug screen. Qualified applicants with arrest records and/or conviction records will be considered for employment in a manner consistent with Federal, State and local laws, including but not limited to the San Francisco Fair Chance Ordinance. All qualified applicants will receive consideration for employment without regards to race, color, religion, sex, national origin, sexual orientation, gender identity, protected veteran status or disability status and any other classification protected by Federal, State and local laws.

Apply Now

Refine Your Search

licensing specialist jobs in san francisco ca

Government Programs Compliance Specialist, Senior

Risk Adjustment Compliance Specialist, Principal

Credentialing and Licensing Specialist III

Safety and Compliance Specialist

Compliance & Outcomes Specialist

Compliance Operations Specialist

Compliance Specialist, SF

Compliance Specialist - San Francisco Corporate Office

Technical Compliance Specialist

Privacy & Compliance Specialist

Sr. Compliance Specialist (Regulated Industry)

Housing Compliance Specialist - Full Time - 40 Hours/Week (PM5)

Compliance Specialist

Qualified SWPPP Developer (QSD) / Senior Environmental Compliance Specialist

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