Joaquin Davis Email & Phone Number

Raleigh-Durham, North Carolina Area

Manage the day-to-day activities required to develop and maintain an effective organizational compliance program. Includes the coordination of highly complex, cross functional matters related to Corporate Compliance.Manage the production of all North Carolina Department of Insurance complaint and SmartNC Inquiry responses for Blue Cross NC. Manage staff efforts to maintain organizational compliance with existing laws, regulations, and requirements.Identifies and takes action regarding needed process and procedural changes.Utilize significant expertise in the compliance and regulatory field to address multifaceted, enterprise wide, highly complex compliance questions and problems.Employ analytic skills to discover trends in the complaints and inquiries received by the enterprise. 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. Manage the development and implementation of training and other communication for employees and external entities. Manage staff of department, including coaching, mentoring, career development, and performance management. Enhance collaborative relationships with the North Carolina Department of Insurance.

Ensure compliance with state/federal laws and regulations, Blue Cross Blue Shield Association requirements, Medicare guidance, and/or bid requirements through management and facilitation.Identify and analyze enterprise-wide complex regulatory compliance inquiries and issues.Research, investigate, and evaluate compliance implementation initiatives and required remediation initiatives including implementation of state/federal laws and regulations, Blue Cross Blue Shield Association requirements, and/or Medicare guidance and bid requirements.Monitor operational metrics and indicators related to compliance performance and coordinate activities related to non-financial regulatory audits. Perform risk assessments and audits to monitor business systems for compliance. Assure appropriate implementation and corrective action is taken to address risks and issues identified.Review operational policies for compliance adherence and provide feedback to business areas.Analyze and assess enterprise-wide environment and compliance program needs. Recommend compliance programming and compliance initiatives.Analyze enterprise business processes for compliance with the current Affordable Care Act requirements. Responsible for design and implementation of the Centers for Medicare & Medicaid Services' Health Insurance Casework System (HICS) processing workflow at Blue Cross Blue Shield NC while serving as a subject matter expert. Blue Cross Blue Shield NC became one of the top five HICS case processing health insurance issuers in the nation due to my leadership.

Responsible for the supervision of Underwriting Processing, Underwriting Processing Support, Telephone Interview, and Membership Maintenance teams for fully insured under age 65 market segment. (25+ direct reports)Provide oversight to ensure tracking and ongoing assessment of performance metrics, including productivity, quality and audit measures.Work closely with key business partners to comply with organizational, Legal and DOI guidelines and regulations.Serve as a key contributor on corporate and divisional projects.Introduced automation of metric reporting to eliminate self reported production. Oversee the department's implementation of User Acceptance Testing Release Weekends.Manage the department's flexible work options efforts. Responsible for process reviews and workflows.Managed the department's contractor programs which included coordinating interview sessions, onboarding, training, shadowing, and resource allocation. Served as the liaison between the business and the contingent labor vendor. Picked to serve on committee that evaluated vendors and picked the company's first supplier of Contingent Workforce Management. Serve as Manger of the Underwriting Risk Review Committee. In charge of developing and maintaining the departments tools to produce and compare mid-year and end-of-year Individual Plan of Work metric review rankings for employees. Responsible for transitioning my teams' processes to Healthcare Reform standards.Nominated and elected as Treasurer of Blue Cross Blue Shield of North Carolina AABEN diversity employee network.Selected to Blue Cross Blue Shield of NC Blue Xchange mentorship program. Selected as emerging leader for the Blue Cross Blue Shield of NC Emerging Leader/Team Leader Academy leadership development program.

Helped customers in fulfillment, application status, resequencing, and BOL technical situations.Trained new hires to the position.Used the applicants' life factors to determine plan best suited for them.

Taught Keyboarding to 6, 7th, and 8th grades.Taught Business Marketing to 7th and 8th grades.Head coach for Football and Wrestling teams.

Managed all aspects of store operations while contributing to profits as a Sales professional.Performed managerial duties including hiring, scheduling, payroll, inventory and marketing.Handled all loss prevention duties and interactions.