Anthem Regulatory Compliance Manager - (PS14515) in Elmhurst, Illinois

Regulatory Compliance Manager - (PS14515)

New

Location: United States

Field: Fraud

Requisition #: PS14515

Post Date: 9 hours ago

Anthem, Inc. is one of the nation's leading health benefits companies and a Fortune Top 50 company. At Anthem, Inc., we are working together to transform health care with trusted and caring solutions.

Bring your expertise to our innovative culture where you will have the opportunity to make a difference in people’s lives, and to take your career further than you can imagine.

Regulatory Compliance Manager

Responsible for managing regulatory compliance functions for Medicare Advantage and related products, including federal and state regulatory compliance, communications compliance and policy language development.

Primary duties may include, but are not limited to:

  • Manages compliance oversight for provider data and provider quality.

  • Develops, implements and maintains formal compliance structure and computer and filing systems for compliance materials.

  • Creates the structure and processes necessary to manage Compliance integration activities across the Medicare enterprise.

  • Manages process for drafting all policy language and reviews all written materials for compliance with state and federal regulations, as well as contractual requirements.

  • May interact with legal department and public policy to review and evaluate required federal and state regulatory filings.

  • Supports Medicare Advantage business areas with oversight of Compliance Plan and Risk Register.

  • Partners with business areas to triage compliance questions as well as escalate any compliance issues in a timely manner.

Preferred Locations

1831 Chestnut Street, St. Louis MO

4361 Irwin Simpson Road (Bldg. I) Mason, Ohio

11 Corp. Woods Blvd. Albany , NY

13550 Triton Park Blvd. Louisville , KY

N17 W24340 Riverwood Drive Waukesha WI

This position will allow you to work in any Anthem office, work from home is not an option

Regulatory Compliance Manger

Requires

BA/BS degree in a related field,

5 - 7 years related regulatory or contract compliance with ability to analyze, write and integrate highly technical information into action plans;

Any combination of education and experience which would provide an equivalent background.

Ability to communicate effectively with executive leadership and regulators.

Preferred

Experience with CMS and/or provider data management activities for complex health plans