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Regulatory Compliance Manager 128453 job

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Anthem Inc. jobs
Country:  United States
Job Category:  Other
Your Talent. Our Vision. At Anthem, Inc., it's a powerful combination, and the foundation upon which we're creating greater access to care for our members, greater value for our customers, and greater health for our communities. Join us and together we will drive the future of health care.

This is an exceptional opportunity to do innovative work that means more to you and those we serve at one of America's leading health benefits companies and a Fortune Top 50 Company.

There are two (2) positions available.

Location: Preferred locations include Denver, CO; Mason, OH; St. Louis, MO; Pewaukee, WI; but will consider other locations.

Responsible for managing, overseeing and contributing to the external audit, monitoring, compliance and risk functions for Medicare.

Primary duties may include, but are not limited to:
  • Leads, coordinates, participates and resolves monitoring and oversight reviews.
  • Participates in risk assessment activities including identification, assessment and monitoring of risk.
  • Leads, coordinates, participates and resolves audit requests from Center for Medicare and Medicaid Services (CMS), Office of the Inspector General (OIG) or other regulatory authorities to ensure accurate and timely resolution of internal/ external audits.
  • Leads, coordinates and participates in managing audit planning, conducting mock audits, conducting audit training, managing audit evidence preparation, assessing the quality of audit evidence and audit preparedness.
  • Participates in the execution of onsite and/or desk audits and collecting anticipated audit findings.
  • Assists Medicare in responding to audit reports by developing, implementing and monitoring Corrective Action Plans.
  • Collects and prepares data for required reporting.
  • Creates and does presentation on various audit/risk topics to a variety of audiences.
  • Communicates crucial guidance and information to business owners timely and accurately.
  • Provides interpretation of guidance to Medicare.
  • Accountable for the ensuring reporting and documentation of the auditing procedures are in place.
  • Leads and facilitates meetings to ensure the engagement with internal and external stakeholders.
  • Responds to calls from external and internal stakeholders for guidance and facilitation of audits.

  • Requires BA/BS degree in a related field required, MBA/MA preferred.
  • 5 - 7 years related regulatory or contract compliance with ability to analyze, write and integrate highly technical information into action plans; or any combination of education and experience which would provide an equivalent background.
  • Medicare care experience required. Must be proficient with Excel, Word and PowerPoint. Experience with CMS audits preferred.
  • Experience with risk assessment, monitoring reviews a plus.

Anthem, Inc. is ranked as one of America's Most Admired Companies among health insurers by Fortune magazine and is a 2016 DiversityInc magazine Top 50 Company for Diversity. To learn more about our company and apply, please visit us at EOE. M/F/Disability/Veteran.

Employer:  Anthem Inc.


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