Anthem, Inc. Compliance Director in Mason, Ohio
SHIFT: Day Job
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 care companies and a Fortune Top 50 Company.
This position has the ability to sit at any Anthem office with possibility to work remote. This position will be an individual contributor.
Responsible for directing foundational and strategic compliance responsibilities with consistent excellence that support the Medicare Advantage team and management.
Primary duties with expert skill level and tasks with the most advanced complexity and broad/enterprise scale may include, but are not limited to:
Directs projects, initiatives, regulatory sanctions, executive-sponsored initiatives, internal audits, accreditations, on-site reviews, risk assessments; audit planning, conducting mock audits, conducting audit training, discovery and research of internal and external opportunities and partnering strategies for Medicare Business. Conducts in-depth strategic research, provides analytical support including analysis and synthesis of business, technical, government documents with a high attention to detail.
Leads compliance monitoring to identify process gaps, validate compliance levels, map processes, draft corrective actions/remediation plans, oversee implementation of corrective actions, prepare reports/presentations.
Supports CMS and State Agency audit and readiness facilitation across multiple markets.
Develops strategic plans, makes recommendations to leadership; design and execute the annual compliance plan.
Develop strong relationships with key leaders to identify and address compliance risks and failures and manage action plans designed to fully mitigate risk(s).
Requires a BA/BS and minimum of 8 years of health care, regulatory, ethics, compliance or privacy experience; or any combination of education and experience, which would provide an equivalent background
MS/MBA/JD or professional designation preferred.
Regulatory or contract compliance is preferred.
Project management experience is preferred.
Familiarity with alliances and joint ventures is preferred.
Medicare experience is preferred-familiarity with Special Needs Plans and specifically Dually Eligible products such as D-SNPs and MMPs. 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. The health of our associates and communities is a top priority for Anthem. We require all new candidates to become vaccinated against COVID-19. If you are not vaccinated, your offer will be rescinded unless you provide – and Anthem approves – a valid religious or medical explanation as to why you are not able to get vaccinated that Anthem is able to reasonably accommodate. Anthem will also follow all relevant federal, state and local laws. Anthem, Inc. has been named as a Fortune 100 Best Companies to Work For®, is ranked as one of the 2020 World’s Most Admired Companies among health insurers by Fortune magazine, and a 2020 America’s Best Employers for Diversity by Forbes. To learn more about our company and apply, please visit us at careers.antheminc.com. Anthem is an Equal Employment Opportunity employer and all qualified applicants will receive consideration for employment without regard to race, color, religion, sex, age, national origin, protected veteran status, disability status, sexual orientation, gender identity or expression, marital status, genetic information, or any other characteristic protected by law. Applicants who require accommodation to participate in the job application process may contact firstname.lastname@example.org for assistance.