Anticipated End Date:

2024-08-16

Position Title:

Compliance Director

Job Description:

Compliance Director

Location: Must be located in Nevada.

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 Director owns oversight to ensure monitoring is performed compliance with the Nevada state contract requirements and connects with state plan leaders and centralized government business process leaders to understand business level monitoring of compliance with state requirements. 

The Compliance Director is the central driver of issue remediation, confirming our business partners understand and address the root cause and control breakdowns that lead to member, provider, and state complaints/issues. 

How You Will Make an Impact

Primary duties with advanced complexity and broad/enterprise scale may include, but are not limited to:

• Driver of issue remediation, confirming our business partners understand and address the root cause and control breakdowns that lead to member, provider, and state complaints/issues. 

• Reviewing state defined quality metrics performance, vendor and affiliate monitoring and audit performance.

• Oversee health plan implementation of new local and enterprise-wide initiatives.

• Researches and responds to questions about requirements in the contract, and state-based interpretation and enforcement of those requirements and owns the Nevada Medicaid Compliance Committee.

• Supports business development and maintenance of the contract through request for proposal support. Supports health plan leaders with business operational reviews with senior Medicaid leadership.

• Meets with the key regulatory contacts biweekly or more often as needed, ensuring the health plan is meeting regulatory expectations. 

• Supports Elevance’s Audit COE in understanding the state requirements that are being audited against, and the key state health plan leaders (local and centralized) responsible for each area of the audit.

• Review collateral and member messaging developed that would be distributed to members for the state (local, compliance related, and centralized).

• Performs reviews of policies and procedures developed locally, and for centralized support to ensure compliance with state contracts.

• Hires, trains, coaches, counsels, and evaluates performance of direct reports.

​

​ Minimum Requirements:

• Requires a BA/BS and minimum of 8 years health care, regulatory, ethics, compliance or privacy experience, including minimum of 3 years management experience; or any combination of education and experience, which would provide an equivalent background.

Preferred Skills, Capabilities, and Experiences:

• Managed care operations experience highly preferred.

• Strong leadership/managerial skills and ability to motivate/coach other staff strongly preferred.  

• MS/MBA or professional designation preferred.

For candidates working in person or remotely in the below location(s), the salary* range for this specific position is $109, 872 to $164,808.

Location: Nevada

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.

Job Level:

Director Equivalent

Workshift:

1st Shift (United States of America)

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.