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Anthem, Inc. Compliance Director in Columbia, South Carolina

Description

SHIFT: Day Job

SCHEDULE: Full-time

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

The Compliance Director role is responsible for the partnership, support, and oversight of all areas within the business that support Risk Adjustment related submissions to CMS. This role will need an in-depth experience on how Medicare claims and encounters are received, processed, and ultimately submitted to CMS as encounters and RAPS data.

Primary duties may include, but are not limited to:

  • Directs projects, initiatives, regulatory sanctions, executive-sponsored initiatives, regulatory audits or exams, internal audits, accreditations, on-site reviews, risk assessments; audit planning, conducting mock audits, conducting audit training, managing audit evidence preparation, assessing audit preparedness.

  • 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.

  • Leads complex investigations and documents findings.

  • Develops strategic plans, makes recommendations to leadership; designs/implements 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).

Qualifications

Minimum Qualifications:

  • Requires a BA/BS and minimum of 8 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.

  • Excellent analytical, organizational, planning, oral and written communication skills

    Preferred Qualifications:

  • Strong leadership/managerial skills and ability to motivate/coach other staff strongly preferred.

  • Experience with Medicare claims & encounters strongly preferred.

  • MS/MBA/JD or professional designation preferred

    Applicable to Colorado Applicants Only

    Annual Salary Range*: $122,100 – $146,520

    Actual compensation may vary from posting based on geographic location, work experience, education and/or skill level.

    • The hourly or salary range is the range Anthem in good faith believes is the range of possible compensation for this role at the time of this posting. The Company may ultimately pay more or less than the posted range. This range is only applicable for jobs to be performed in Colorado. This range may be modified in the future. No amount is considered to be wages or compensation until such amount is earned, vested, and determinable under the terms and conditions of the applicable policies and plans. The amount and availability of any bonus, commission, benefits or any other form of compensation and benefits that are allocable to a particular employee remain in the Company's sole discretion unless and until paid and may be modified at the Company’s sole discretion, consistent with the law.

    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. 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. An Equal Opportunity Employer/Disability/Veteran. Anthem promotes the delivery of services in a culturally competent manner and considers cultural competency when evaluating applicants for all Anthem positions.

    REQNUMBER: PS58799-US

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