Anthem Regulatory Compliance Manager #133981 in Las Vegas, Nevada
WellPointis one of the nation's leading health benefits companies and a Fortune Top 50 company. At WellPoint, we are working together to transform health care with trusted and caring solutions.
Bring your expertise to our innovative culture where you will have the opportunity to make a difference in people’s lives, and to take your career further than you can imagine.
Regulatory Compliance Manager Mason, OH; Chicago, IL; Milwaukee, WI; Denver, CO; St. Louis, MO preferred.
Responsible for managing regulatory compliance functions for the Medicare Advantage and related products, including federal and state regulatory compliance, communications compliance and policy language development.
Primary duties may include, but are not limited to: * Manages Compliance oversight for Clinical and Grievances & Appeals.
Develops, implements, and maintains formal compliance structure and computer and filing systems for compliance materials.
Create the structure and processes necessary to manage Compliance integration activities across the Medicare enterprise for current and upcoming business.
Manages process for drafting all policy language and reviews all written materials for compliance with state and federal regulations, as well as contractual requirements.
Interacts with legal department and public policy to review and evaluate required federal and state regulatory filings.
Support Medicare Advantage business areas with oversight of Compliance Plan and Risk Register.
Requires BA/BS degree in a related field, 5 - 7 years related regulatory or contract compliance with ability to analyze, write and integrate highly technical information into action plans; ability to communicate effectively to executive leadership and regulators; any combination of education and experience which would provide an equivalent background. Experience with Clinical, Grievances & Appeals or CMS' Complaints Tracking Module (CTM), preferred. Experience with Special Needs Plans (SNP), also preferred.
/ WellPoint is ranked as one of America’s Most Admired Companies among health insurers by Fortune magazine, and is a 2014 DiversityInc magazine Top 50 Company for Diversity. To arn more about our company please visit us at www.wellpoint.com/careers . EOE. M/F/Disability/Veteran. /
Equal Employment Opportunity Statement Anthem, Inc. will recruit, hire, train and promote persons in all job titles without regard to age, color, disability, gender (including gender identity), marital status, national origin, race, religion, sex, sexual orientation, veteran status, or other status protected by applicable law. In addition, all personnel actions such as compensation, promotion, demotion, benefits, transfers, staff reductions, terminations, reinstatement and rehire, company-sponsored training, education and tuition assistance, and social and recreational programs will be administered in accordance with the principles of equal employment opportunity.
Title: Regulatory Compliance Manager #133981
Location: nevada-Las Vegas
Other Locations: OH-Mason, WI-Milwaukee, CO-Denver, IL-Chicago, MO-St. Louis
Requisition ID: 133981