Anticipated End Date:

2024-09-09

Position Title:

Compliance Consultant -KanCare

Job Description:

Compliance Consultant

Location: Candidates must reside within 50 miles or 1-hour commute each way of any open access Elevance Health location.

This position will take part in Elevance Health's hybrid workforce strategy which includes virtual work and 1-2 days in office per week.

The Compliance Consultant is responsible for delivering and executing foundational compliance responsibilities that support the team and management at the advanced level.

How You Will Make an Impact:

The primary focus of this position is to ensure Elevance Health is consistently meeting the reporting requirements stipulated under State regulatory bodies. This role encompasses:

• Identifying newly introduced or modified reporting prerequisites

• Communicating details of report specifications - this includes timelines for reporting, formatting preferences, and required components

• Coordination across health plans, product lines, and corporate business areas to define report accountability and responsibilities

• Submitting reports to regulatory agencies on time

• Problem-solving support and guidance for report issue resolution

• Maintenance of reporting technologies to ensure efficient report metric tracking

• Building strong and sturdy partnerships within the Elevance Health organization to facilitate accomplishment of position responsibilities and goals

• At a moderate level, this position will necessitate understanding contracts, researching regulations, and comprehending report submission requirements

• Provide high-level support as the subject matter expert in regulatory reporting for regulatory audits or exams, internal audits, accreditations, on-site reviews, and risk assessments.

• Working within a matrix environment to collaborate and support analysis and review of reporting information for compliance

• Actively taking part in Compliance Committee meetings to communicate findings and mitigate potential risks

• Applying effective oversight to identify process gaps, ensure compliance, document reporting processes, and support remedial actions for delinquent and/or inaccurate reporting

• Conducting investigations, documenting findings, ensuring stakeholders and leadership are updated on reporting developments and issues, fulfilling notification requirements, and participate in corrective action monitoring.

Minimum Requirements:

• Requires a BA/BS and minimum of 3 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:

• Proficiency in Microsoft Office Suite (Word, Excel, and PowerPoint) is a highly preferred.

• Experience in working with databases.

• Working knowledge of managed care and an ability to comprehend contracts, laws, and legislation will be advantageous.

• Candidate must have strong verbal and written communication skills.

• The ability to communicate effectively across all levels of the business is essential.

Job Level:

Non-Management Exempt

Workshift:

Job Family:

FRD > Compliance

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 [email protected] for assistance.