Compliance Manager

at Elevance Health in South Portland, Maine, United States

Job Description

WARNING: Please beware of phishing scams that solicit interviews or promote work-at-home opportunities, some of which may pose as legitimate companies. Elevance Health requires a completed online application for consideration of employment for any position. We will never ask you for a credit card, send you a check, or ask you for payment as part of consideration for employment.

Compliance Manager

+ Job Family: Enterprise Operations

+ Type: Full time

+ Date Posted:Dec 08, 2023

+ Req #: JR96167



+ Georgia, Midland

+ Colorado, Denver

+ Washington, Seattle

+ Minnesota, Mendota Heights

+ Louisiana, Metairie

+ New York, New York City

+ New York, Middletown

+ Ohio, Seven Hills

+ New Jersey, Iselin

+ California, Woodland Hills

+ Ohio, Mason

+ New York, Latham

+ California, Walnut Creek

+ Georgia, Atlanta

+ Ohio, Columbus

+ Tennessee, Nashville

+ Indiana, Indianapolis

+ Ohio, Cincinnati

+ Rhode Island, Smithfield

+ Florida, Tampa

+ Massachusetts, Woburn

+ New Hampshire, Manchester

+ California, Costa Mesa

+ District of Columbia

+ North Carolina, Raleigh

+ Delaware, Wilmington

+ Iowa, West Des Moines

+ Nevada, Las Vegas

+ Connecticut, Wallingford

+ Virginia, Roanoke

+ Texas, Houston

+ Texas, Grand Prairie

+ Maryland, Hanover

+ Florida, Miami

+ Virginia, Norfolk

+ West Virginia, Charleston

+ Maine, South Portland

+ New Jersey, Morristown


Compliance Manager

Locations: Louisville, KY; Indianapolis, IN; Costa Mesa, CA; Walnut Creek, CA; Woodland Hills, CA; Denver, CO; Washington, DC; Miami, FL; Tampa, FL; Atlanta, GA; West Des Moines, IA; Metairie, LA; Woburn, MA; Hanover, MD; South Portland, ME; Mendota Heights, MN; Latham, NY; Nashville, TN; Richmond, VA; Roanoke, VA; Seattle, WA; Charleston, WV; Wallingford, CT; Wilmington, DE; Midland, GA; Cary, NC; Manchester, NH; Iselin, NJ; Morristown, NJ; Las Vegas, NV; Middletown, NY; New York, NY; Cincinnati, OH; Columbus, OH; Mason, OH; Seven Hills, OH; Smithfield, RI; Grand Prairie, TX; Houston, TX; Norfolk, VA

Elevance Health operates in a Hybrid Workforce Strategy, providing various levels of flexibility while also ensuring that associates have opportunities to connect in-person. Unless in a designated virtual-eligible role and 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 Compliance Manager will be responsible for becoming an expert in all laws, regulations, and expected processes pertaining to Medicare Risk Adjustment data submissions.

How You Will Make an Impact:

Primary duties may include, but are not limited to:

+ The Medicare Managed Care Manual Chapter’s 7 and 21, the Encounter Data Submission and Processing Guide, all underlying regulations, etc.

+ This role will review new CMS guidance related to this area and provide interpretation of this guidance to associated business area and work with those areas around implementation.

+ This role will work in collaboration with other Medicare compliance experts related to upstream processes, and escalate bottlenecks or issues with data flow through when they are found to compliance and business leaders.

+ This role will help business partners design effective remediation when issues are detected, and validate that remediation once complete.

+ This role will support the business in providing compliance guidance as it related to day to day operations questions and special projects.

+ Ability to travel may be required.

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, whi

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Job Posting: JC251607960

Posted On: Nov 27, 2023

Updated On: Dec 12, 2023

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