Brian Goble Email & Phone Number

Raleigh-Durham-Chapel Hill Area

• Lead the development of the strategy, planning and execution necessary to effectively implement legislation and facilitate implementation of processes that ensure compliance and achieve operational effectiveness and efficiencies.• Lead complex multiple work projects and/or collaborative work efforts to ensure BCBSNC compliance with laws and regulation governing the business and to ensure that other significant changes needed to reduce risks and impacts to the organization are remediated.• Develop and deliver training materials and presentations for the enterprise, business owner(s), employees, and Board of Trustees summarizing regulatory/Medicare requirements and engage them in compliance initiatives.• Develop and maintain appropriate monitoring and oversight functions, including compliance metrics reports.• Establish standards and procedures for regulatory/Medicare reporting and documentation, monitoring results against specifications, and investigation and mitigation of compliance issues• Manage the Company’s relationship with state and federal regulators regarding compliance and regulatory matters. Participate in Regulatory Compliance/Medicare Compliance Subcommittee and report to the Enterprise Risk Committee, Compliance Committee and Audit Committee of the Board on the status of the compliance program, including instances of non-compliance and remediation initiatives.• Provide leadership, vision and direction to the team, including accountability for decisions. Manage the staff of the department. This includes performance management, coaching, conflict resolution and motivating and engaging. Manage growth and development of personnel, with career development, performance management and succession planning.• Accountable for the oversight of Risk Management within the Regulatory Compliance Department to ensure that controls are in place to avoid and/or mitigate risk.

Raleigh-Durham, North Carolina Area

• Manage staff efforts to maintain organizational compliance with existing laws, regulations and requirements by leading cross functional projects that may impact a range of critical business processes aligned to key strategic initiatives.• Take actions, makes decisions, and shapes team or group priorities to reflect the organization’s Compliance Program. • Utilize significant expertise in the compliance and regulatory field to address multifaceted, enterprise-wide and highly complex compliance/regulatory questions and problems.• Manage the research, investigation, and evaluation of compliance implementation initiatives and required remediation initiatives.• Provide influential support and consultation to business areas and senior leadership by analyzing and recommending effective solutions to compliance issues to best meet business needs.• Ensure overall compliance with new and existing laws, regulations, obligations, Medicare guidance, and/or bid requirements as required of the Compliance Department• Manage the monitoring of operational metrics and indicators related to compliance performance and coordinate all activities related to non-financial, regulatory audits.• Manage more complex risk assessments and/or audits and monitor business systems for compliance. Assure appropriate implementation and/or corrective action is taken to address risks and issues identified.• Manage the analysis and assessment of enterprise-wide environment and broader compliance program needs. Recommend compliance programming and compliance initiatives to meet those needs.• Manage review of operational policies for compliance and provide feedback to business areas.• Manage the compliance staff of department, including coaching, mentoring, career development and performance management.• Enhance collaborative relationships with regulatory entities, including NCDOI and CMS.

Blue Cross And Blue Shield Of North Carolina

• Monitor and track state and federal legislation and ensure compliance with laws and regulations.• Facilitate and coordinate external regulatory audits and internal mock audits of business operations to ensure compliance with applicable laws and regulations. • Serve as subject matter expert for the Affordable Care Act (ACA) for assigned business areas. • Manage and coordinate complex, cross-functional projects to ensure compliance with new and existing laws and regulations, and provide compliance advice and guidance to projects for major enterprise initiatives.• Research and evaluate compliance implementation initiatives and required remediation initiatives, including implementation of state and federal laws and regulations. • Perform review of marketing materials, medical policies and operational policies for compliance with applicable laws and regulations.• Develop, review and implement training, FAQs and other communications for employees, employer groups, members and other external entities, such as vendors.• Identify, research, and track relevant industry statutes, regulations and guidance to provide current, relevant interpretation.• Facilitate and coordinate external regulatory audits and internal mock audits of business operations and ensure appropriate implementation and/or corrective action is taken to address risks and issues identified.• Present information, such as compliance updates, relevant ACA and health care reform information and regulatory trends to both internal and external audiences at all levels.• Monitor operational metrics and indicators related to compliance performance.• Coordinate and oversee regulatory submissions and reporting activities.

Raleigh-Durham, North Carolina Area

• Monitor and track state and federal legislation and ensure compliance with laws and regulations.• Facilitate and coordinate external regulatory audits and internal mock audits of business operations to ensure compliance with applicable laws and regulations. • Manage and coordinate complex, cross-functional projects to ensure compliance with new and existing laws and regulations.• Identify and analyze enterprise-wide, complex regulatory compliance inquiries and issues.• Serve as compliance subject matter expert for assigned business areas. Research, investigate, and evaluate compliance implementation initiatives and required remediation initiatives, including implementation of state and federal laws and regulations. • Monitor operational metrics and indicators related to compliance performance. • Conduct risk assessments and/or audits and monitor business systems for compliance. Ensure appropriate implementation and/or corrective action is taken to address risks and issues identified.• Develop and implement training and other communications for employees and external entities.• Perform review of medical policies, operational policies and marketing materials for compliance with applicable laws and regulations.• Coordinate and oversee regulatory submission and reporting activities and maintain working relationships with regulators. • Provide support to law department and business areas through analysis and/or consultations.

Raleigh-Durham, North Carolina Area