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Compliance Manager or Compliance Consultant

Location:
JobFamily: Fraud
Req #: PS59916
Date Posted: Oct 8, 2021

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Description:

Description

SHIFT: Day Job

SCHEDULE: Full-time

Your Talent. Our Vision. At Anthem, Inc., it’s a powerful combination, and the foundation upon which we’re creating greater access to care for our members, greater value for our customers, and greater health for our communities. Join us and together we will drive the future of health care.

This is an exceptional opportunity to do innovative work that means more to you and those we serve at one of America's leading health care companies and a Fortune Top 50 Company

Job Description for The Compliance Manager:

Responsible for managing foundational and strategic compliance responsibilities with consistent excellence that supports the team and management.

Primary duties for this managing level position, with moderate to advanced complexity and broad/enterprise-scale, may include, but are not limited to:

  • 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 experts.
  • Conducts complex investigations, document findings, and ensure corrective actions are made. Interface with external clients, regulators, vendors, suppliers; internal stakeholders, high level of management.

Job Description for Compliance Consultant:

Primary duties for this advanced level position, with tasks of routine or least complexity may include, but are not limited to:

  • At the advanced level, report, communicate, research laws at the advanced level, regulations, requirements, regulatory audits and/or exams.
  • Provide advanced level support to regulatory audits or exams, internal audits, accreditations, on-site reviews, risk assessments.
  • At the advanced level, analyze and extract regulatory data, documentation for compliance with requirements.
  • Participate in compliance monitoring to identify process gaps, validate compliance levels, map processes, draft corrective actions/remediation plans.
  • Conduct investigations, document findings, update stakeholders and leadership on developments, comply with notification requirements, ensure corrective actions are made. 

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.

Anthem, Inc. has been named as a Fortune 100 Best Companies to Work For®, is ranked as one of the 2020 World’s Most Admired Companies among health insurers by Fortune magazine, and a 2020 America’s Best Employers for Diversity by Forbes. To learn more about our company and apply, please visit us at careers.antheminc.com. An Equal Opportunity Employer/Disability/Veteran. Anthem promotes the delivery of services in a culturally competent manner and considers cultural competency when evaluating applicants for all Anthem positions.

Qualifications

Minimum Qualifications for Compliance Manager:

  • Requires a BA/BS and a 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.
  • Ability to travel may be required.

Preferred Qualifications: 

  • MS/MBA/JD or professional designation preferred.
  • Medicaid managed care operations experience (Customer Care or Grievance and Appeals) is strongly preferred.

Minimum Qualifications for Compliance Consultant:

  • Requires a BA/BS, 3-5 years of health care, regulatory, ethics, compliance, or privacy experience; or any combination of education and experience, which would provide an equivalent background.
  • Ability to travel may be required.

Preferred Qualifications:

  • Operational experience which includes Customer Service, Grievance, and Appeal or Claims strongly preferred.

Applicable to Colorado Applicants Only

Annual Salary Range*: $97,000 – $116,400

Actual compensation may vary from posting based on geographic location, work experience, education, and/or skill level.

 * The hourly or salary range is the range Anthem in good faith believes is the range of possible compensation for this role at the time of this posting.  The Company may ultimately pay more or less than the posted range. This range is only applicable for jobs to be performed in Colorado. This range may be modified in the future.  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 remain 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 Anthem only accepts resumes from agencies that have a signed agreement with Anthem. Accordingly, Anthem is not obligated to pay referral fees to any agency that is not a party to an agreement with Anthem. Thus, any unsolicited resumes, including those submitted to hiring managers, are deemed to be the property of Anthem.