Risk Adjustment Compliance Manager

Elevance Health•Indianapolis, IN

23h•Hybrid

About The Position

The Risk Adjustment Compliance Manager is 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 day 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. Ideal candidates will be able to report to one of our Pulse Point locations in Atlanta, GA, Indianapolis, IN, Mason, OH or Norfolk, VA. Alternate locations may be considered if candidates reside within a commuting distance from an office. Elevance Health is a health company dedicated to improving lives and communities – and making healthcare simpler. They are a Fortune 25 company with a longstanding history in the healthcare industry, looking for leaders at all levels of the organization who are passionate about making an impact on their members and the communities they serve. Elevance Health operates in a Hybrid Workforce Strategy, requiring associates to work at an Elevance Health location at least once per week.

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

MS/MBA/JD or professional designation preferred.

Responsibilities

Partner with Encounters SMEs to resolve issues, mitigate risk, and enhance processes.
Manage and track compliance items in C360.
Utilize data skills to understand scope/impact of policy/process changes – both proactively and in response to changing regulations and oversight.
Manage/oversee projects, initiatives, regulatory audits or exams, internal audits, accreditations, on-site reviews, risk assessments and audit planning.
Conduct mock audits and audit training.
Manage audit evidence preparation.
Assess audit preparedness.
Establish project plans, gap analysis, milestone dates, leadership updates and other significant aspects.
Maintain knowledge of laws, regulations, company strategies to assess impact.
Consult with clients as subject matter expert.
Conduct complex investigations, document findings, and ensure corrective actions are made.
Interface with external clients, regulators, vendors, suppliers, internal stakeholders, and high levels of management.