Compliance Manager

Elevance Health • Norfolk, VA

4d • Hybrid

About The Position

The Compliance Manager serves as a key leader within the Carelon Insights Payment Integrity Regulatory Compliance (PIRC) organization, with primary responsibility for the oversight and management of Commercial Compliance activities. This position plays a vital role in ensuring the organization’s adherence to regulatory requirements, maintaining operational excellence, and advancing Carelon Insights Payment Integrity compliance objectives across multiple commercial markets. The position also partners closely with cross-functional stakeholders, including business leaders, regulators, and internal governance teams, to promote transparency, accountability, and consistent adherence to compliance standards. This position requires strategic thinking, sound judgment, and the ability to navigate a highly regulated and dynamic environment. Serve as a trusted advisor and compliance leader within the Payment Integrity organization, strengthening regulatory alignment, reducing risk exposure, and supporting a culture of integrity and continuous improvement.

Requirements

• Requires a BA/BS and 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.

Nice To Haves

• An advanced degree (MS, MBA, or JD) or a professional certification (e.g., CHC, CCEP, CHPC) is preferred.
• Candidates should possess demonstrated experience leading compliance programs or audits of moderate to high complexity, along with exceptional communication, analytical, and leadership skills.
• Commercial compliance experience preferred.
• Demonstrated success leading compliance programs or audits of moderate to high complexity.
• Strong communication, analytical, and leadership skills.
• Proven ability to assess regulatory impacts, manage risk, and implement effective compliance solutions.
• Experience with compliance tools and systems such as SharePoint, Doctract, CONTRAXX, or ServiceNow.

Responsibilities

• Provides strategic direction and oversight for regulatory audits and examinations, internal audits, accreditations, risk assessments, and other compliance reviews.
• Developing and executing audit plans, conducting gap analyses, managing audit preparedness, coordinating evidence collection, and delivering regular leadership updates on compliance status and risk mitigation efforts.
• Serves as a subject matter expert, maintaining an advanced understanding of applicable laws, regulations, and company policies to anticipate compliance risks, assess potential impacts, and guide decision-making.
• Oversees several critical compliance tools and processes, including PI SME for the CONTRAXX system, Doctract and ServiceNow (SNOW) issue management.
• Ensures that all compliance mandates are effectively tracked, resolved, and documented in a timely manner.

Benefits

• 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.

What This Job Offers

• Job Type: Full-time
• Career Level: Manager
• Number of Employees: 5,001-10,000 employees