Compliance Manager
Elevance Health

Job Info

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Compliance Manager

Location: This position will work a hybrid model (remote and office). The Ideal candidate will live within 50 miles of one of our Elevance Health PulsePoint locations.

The Compliance Manager will be responsible for managing foundational and strategic compliance responsibilities with consistent excellence that support the team and management. The Compliance Manager is part of the Medicaid Compliance Business Development Team and oversees Medicaid Implementations by supporting state-mandated readiness reviews. This position acts as the implementation lead and are the liaisons for our State Agencies during the implementation. They serve as interim Medicaid Compliance Officers/Contract Managers until Go Live where the responsibilities are then transitioned to the Plan Compliance Officer and Health Plan.

How you will make an impact:

• Collaborate with business partners on interpreting readiness review requirements; universe audits; reporting submissions; and State regulator interface and communications. This includes facilitating meetings and leading on site readiness reviews.
• Work closely with the Government Business Execution Team and Medicaid Plan Compliance Officers in varying markets.
• Manage/oversee projects, initiatives, regulatory audits or exams, internal audits, accreditations, on-site reviews, risk assessments; audit planning, conducting mock audits, conducting audit training, managing audit evidence preparation, assessing audit preparedness.
• Establish project plans, gap analysis, milestone dates, and other significant aspects, and leadership updates.
• Maintain knowledge of laws, regulations, company strategies to assess impact, and consult with clients as subject matter expert.
• Conducts complex investigations, document findings, and ensure corrective actions are made.
• Interface with external clients, regulators, vendors, supplier; internal stakeholders, high level of management.
• Travels to worksite and other locations as necessary.

Minimum Requirements:

Requires a BA/BS and minimum of 6 years health care, regulatory, ethics, compliance or privacy experience; or any combination of education and experience, which would provide an equivalent background.

Preferred Skills, Capabilities, and Experiences:

• MS/MBA/JD or professional designation preferred.
• Prior project management experience preferred.
• Experience with SharePoint and Excel highly preferred.
• Familiarity with JIRA preferred.

Please be advised that Elevance Health only accepts resumes for compensation from agencies that have a signed agreement with Elevance Health. Any unsolicited resumes, including those submitted to hiring managers, are deemed to be the property of Elevance Health.

Who We Are

Elevance Health is a health company dedicated to improving lives and communities - and making healthcare simpler. We are a Fortune 25 company with a longstanding history in the healthcare industry, looking for leaders at all levels of the organization who are passionate about making an impact on our members and the communities we serve.

How We Work

At Elevance Health, we are creating a culture that is designed to advance our strategy but will also lead to personal and professional growth for our associates. Our values and behaviors are the root of our culture. They are how we achieve our strategy, power our business outcomes and drive our shared success - for our consumers, our associates, our communities and our business.

We offer a range of market-competitive total rewards that include merit increases, paid holidays, Paid Time Off, and incentive bonus programs (unless covered by a collective bargaining agreement), medical, dental, vision, short and long term disability benefits, 401(k) +match, stock purchase plan, life insurance, wellness programs and financial education resources, to name a few.

Elevance Health operates in a Hybrid Workforce Strategy. Unless specified as primarily virtual by the hiring manager, associates are required to work at an Elevance Health location at least once per week, and potentially several times per week. Specific requirements and expectations for time onsite will be discussed as part of the hiring process. Candidates must reside within 50 miles or 1-hour commute each way of a relevant Elevance Health location.

The health of our associates and communities is a top priority for Elevance Health. We require all new candidates in certain patient/member-facing roles to become vaccinated against COVID-19. If you are not vaccinated, your offer will be rescinded unless you provide an acceptable explanation. Elevance Health will also follow all relevant federal, state and local laws.

Elevance Health is an Equal Employment Opportunity employer and all qualified applicants will receive consideration for employment without regard to age, citizenship status, color, creed, disability, ethnicity, genetic information, gender (including gender identity and gender expression), marital status, national origin, race, religion, sex, sexual orientation, veteran status or any other status or condition protected by applicable federal, state, or local laws. Applicants who require accommodation to participate in the job application process may contact elevancehealthjobssupport@elevancehealth.com for assistance.

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