Compliance Manager (US)

Elevance Health•Atlanta, IL

1d•Hybrid

About The Position

The Compliance Manager will be responsible for managing foundational and strategic compliance responsibilities with consistent excellence that support the team and management. This role requires associates to be in-office 1 - 2 days per week, fostering collaboration and connectivity, while providing flexibility to support productivity and work-life balance. This approach combines structured office engagement with the autonomy of virtual work, promoting a dynamic and adaptable workplace. Alternate locations may be considered if candidates reside within a commuting distance from an office. Candidates not within a reasonable commuting distance from the posting location(s) will not be considered for employment, unless an accommodation is granted as required by law.

Requirements

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

MS/MBA/JD or professional designation preferred.
Six Sigma certification preferred.
Regulatory compliance experience strongly preferred.
Medicare, Medicaid, and/or Commercial experience strongly preferred.
Regulatory analysis experience strongly preferred.
Utilization management (UM) knowledge and experience strongly preferred.
Health insurance industry experience preferred.
Risk assessment and audit experience preferred.
Client engagement experience preferred.
Strong written and oral communication skills as well as experience presenting to senior leaders up through C-Suite preferred.

Responsibilities

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