Job ID:

Elevance Health is a health company dedicated to improving lives and communities – and making healthcare simpler. Previously known as Anthem, Inc., we have evolved into a company focused on whole health and updated our name to better reflect the direction the company is heading.

We are looking for contract workers (via BCforward) who are passionate about making an impact on our members and the communities we serve. You will thrive in a complex and collaborative environment where you take action and ownership to solve problems and lead change. Do you want to be part of a larger purpose and an evolving, high-performance culture that empowers you to make an impact?

Responsible for delivering and executing foundational compliance responsibilities that support the team and management at the advanced level.

Primary duties 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.
• Resource is needed to support audits and assist with regulatory reporting to avoid financial penalties.

Requirements:

• 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.
• Experience in Medicaid Health Plan Compliance, understanding State and Federal regulations, impact to Medicaid programs and have the ability to support audits.

Additional Details:

• 9-5 EST M-F
• Others duties as assigned

BCForward is An Equal Opportunity Employer. All qualified applicants will receive consideration for employment without regard to race, color, religion, sex, sexual orientation, gender identity, national origin, or protected veteran status and will not be discriminated against on the basis of disability.

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