Risk Adjustment Compliance Manager

Elevance Health • Atlanta, GA

1d • 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. 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. At Elevance Health, they are creating a culture that is designed to advance their strategy but will also lead to personal and professional growth for their associates. Their values and behaviors are the root of their culture, how they achieve their strategy, power their business outcomes and drive their shared success - for their consumers, their associates, their communities and their business.

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.

Benefits

• merit increases
• paid holidays
• Paid Time Off
• incentive bonus programs
• medical
• dental
• vision
• short and long term disability benefits
• 401(k) +match
• stock purchase plan
• life insurance
• wellness programs
• financial education resources

What This Job Offers

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