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Best Practices in Implementing a Compliance Program

Perspective of a Chief Compliance Officer, Blue Cross Blue Shield Tennessee
Date: Tuesday June 07, 2011
Time: 10 am PST | 5 pm GMT
Duration: 1 hour
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As the US health care system undergoes reform, several health insurance providers including BCBS affiliates are stepping up their Governance, Risk and Compliance (GRC) programs by managing their risk programs, streamlining internal audits and ensuring compliance with multiple regulatory requirements and corporate policies. Given the highly regulated nature of the industry, easy access and efficient management of laws, regulations, standards and guidelines as well as translation of this information into actionable tasks is pivotal. A sound GRC technology architecture is going to be a critical component for sustaining compliance, preventing fraud and managing a wide array of risks for the health insurance providers.

Join this webinar hosted by MetricStream having Judith Nelson, Vice President and Chief Compliance Officer, BCBS Tennessee as the key speaker. The webinar will address the following key aspects:

  • Challenges facing the healthcare industry from a risk, compliance and audit perspective
  • Best practices for addressing these challenges
  • Role of technology in adopting and implementing an effective compliance program
  • Case Studies highlighting how select BCBS affiliates architected their compliance program

Panelist

Judith NelsonJudith Nelson - Vice President and Chief Compliance Officer, BCBS Tennessee
Judith Nelson is currently the Vice President and Chief Compliance Officer at BlueCross BlueShield of Tennessee (BCBST). Responsibilities include guiding and directing the enterprise wide compliance program, the Chief Security Officer, as well as the Provider Audit and Enterprise Investigative Services supporting the corporation. The compliance program, coupled with the Code of Conduct and related policies, sets an ethical tone for conducting business and creates a corporate culture that strengthens the reputation of BCBST. An integral program goal is to integrate compliance with management accountabilities and day-to-day business operations.

Judith has twenty plus years of experience in the health insurance industry and has been with BlueCross BlueShield of Tennessee since 1990. Previous responsibilities include health data analysis, utilization and quality management, and provider contracting along with significant project management activities. She received her Bachelor of Science, Business from the University of Tennessee at Chattanooga in 1985.


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