Healthcare Compliance Manager

Healthcare Compliance Manager

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. Please note that per our policy on hybrid/virtual work, 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.

The Healthcare Compliance Manager is responsible for managing foundational and strategic compliance responsibilities with consistent excellence that support the team and management.

How You Will Make An Impact:

• Manage/oversee projects, initiatives, regulatory audits or exams, 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, supplier; internal stakeholders, high level of management.
• Assists in the preparation of responses to regulatory agencies by prescribed timeframes.

Minimum 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.
• Ability to travel may be required.

Preferred Skills, Capabilities & Experiences:

• Experience in commercial insurance compliance & regulation (self-funded, ERISA, ASO, Exchanges) is preferred.
• Experience working in a behavioral health setting is preferred.
• Experience with automation tools are preferred.

Job Level: Non-Management Exempt

Workshift: 1st Shift (United States of America)

Job Family: FRD > Compliance

Elevance Health is a health company dedicated to improving lives and communities and making healthcare simpler. We 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 our members and the communities we serve.

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

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.

Elevance Health operates in a Hybrid Workforce Strategy. Unless specified as primarily virtual by the hiring manager, associates are required to work at an Elevance Health location at least once per week, and potentially several times per week. Specific requirements and expectations for time onsite will be discussed as part of the hiring process.

The health of our associates and communities is a top priority for Elevance Health. We require all new candidates in certain patient/member-facing roles to become vaccinated against COVID-19 and Influenza. If you are not vaccinated, your offer will be rescinded unless you provide an acceptable explanation. Elevance Health will also follow all relevant federal, state, and local laws.

Elevance Health is an Equal Employment Opportunity employer, and all qualified applicants will receive consideration for employment without regard to age, citizenship status, color, creed, disability, ethnicity, genetic information, gender (including gender identity and gender expression), marital status, national origin, race, religion, sex, sexual orientation, veteran status, or any other status or condition protected by applicable federal, state, or local laws. Applicants who require accommodation to participate in the job application process may contact elevancehealthjobssupport@elevancehealth.com for assistance.