Compliance Director

Job Family: Enterprise Operations Type: Full time Date Posted: Nov 27, 2023 Req #: JR96251 Description Elevance Health supports a hybrid workplace model (virtual and in-office) with PulsePoint sites used for collaboration, community, and connection.
This position will take part in the hybrid workforce strategy which includes virtual work and in office days 1-2 times per week.
The Compliance Director is responsible for directing foundational and strategic compliance responsibilities with consistent excellence that support the team and management.
How You Will Make an Impact: Primary duties with expert skill level and tasks with the most advanced complexity and broad/enterprise scale may include, but are not limited to: Directs projects, initiatives, regulatory sanctions, executive-sponsored 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.
Leads compliance monitoring to identify process gaps, validate compliance levels, map processes, draft corrective actions/remediation plans, oversee implementation of corrective actions, prepare reports/presentations.
Leads complex investigations and documents findings.
Develops strategic plans, makes recommendations to leadership; designs/implements annual compliance plan.
Develop strong relationships with key leaders to identify and address compliance risks and failures and manage action plans designed to fully mitigate risk(s).
Review, Research and Maintain knowledge of state and Alliance contract, state and federal laws, regulations, company policies to assess impact, and consult with clients as subject matter expert.
Monitoring and reporting on contractual reporting guarantees, KPI, and associated fines with noncompliance Corrective action plan management, assist in development and monitoring, and partnering with business through resolution Interface with external clients, regulators, vendors, supplier; internal stakeholders, high level of management.
Lead activities for the health plan in its respective interactions with the applicable state Medicaid agency customers and partners Facilitate, monitor and promote understanding of and adherence with the regulatory and contractual obligations to state Medicaid agency customers and partners and responsibility to members Track and ensure that there is a timely and effective response to assure adherence to regulatory/contract amendments and changes Monitor the implementation and effectiveness of compliance program (including leading the compliance committee meetings) Technical Skills 1.
Excel – intermediate to advanced skills (formulas, pivot tables, VLOOKUP) 2.
Access – intermediate skills (able to create a query, run reports) 3.
SharePoint – intermediate to advanced skills (ability to navigate comfortably, post documents, create sites/add web part, work with lists, check in/out documents, assist with clean-up work/record retention) 4.
Analysis/Trending/Reporting 6.
Strong Written and Verbal Communications 7.
Project Management – experience with leading and executing projects Competencies 1.
Ability to multi-task, time management 2.
Relationship management 3.
Influencing 4.
Organized 5.
Decision-making 6.
Collaborative 7.
Timely and concise communication Minimum requirements: Requires a BA/BS and minimum of 8 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: Strong leadership/managerial skills and ability to motivate/coach other staff strongly preferred.
MS/MBA/JD or professional designation preferred.
Travels to worksite and other locations as necessary.
For candidates working in person or remotely in the below locations, the salary* range for this specific position is $102,560 to $184,608 Locations: California; Colorado; Nevada; New York; Washington State; Jersey City, NJ In addition to your salary, Elevance Health offers benefits such as, a comprehensive benefits package, incentive and recognition programs, equity stock purchase and 401k contribution (all benefits are subject to eligibility requirements).
The salary offered for this specific position is based on a number of legitimate, non-discriminatory factors set by the company.
The company is fully committed to ensuring equal pay opportunities for equal work regardless of gender, race, or any other category protected by federal, state, and local pay equity laws .
* The salary range is the range Elevance Health in good faith believes is the range of possible compensation for this role at the time of this posting.
This range may be modified in the future and actual compensation may vary from posting based on geographic location, work experience, education and/or skill level.
Even within the range, the actual compensation will vary depending on the above factors as well as market/business considerations.
No amount is considered to be wages or compensation until such amount is earned, vested, and determinable under the terms and conditions of the applicable policies and plans.
The amount and availability of any bonus, commission, benefits, or any other form of compensation and benefits that are allocable to a particular employee remains in the Company's sole discretion unless and until paid and may be modified at the Company’s sole discretion, consistent with the law.
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.
comfor assistance.