Risk Adjustment Compliance Manager
Elevance Health•Indianapolis, IN
•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.
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
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What This Job Offers
Job Type
Full-time
Career Level
Manager
