- A primary function includes identification, research, analysis and communication of state and federal legislation and regulations.
- Ability to identify regulatory trends, communicate effectively with leadership, clients and other stakeholders to ensure requirements are implemented timely.
- Conducts surveillance of federal and state mandates.
- Tracks impacted mandates for internal monitoring.
- Complete in-depth analysis of mandates for impact to the organization
- Communicates with internal stakeholders to ensure process aligns with requirements.
- Creates trending and other reports for leadership.
- Develops, implements, and maintains formal compliance structure and computer and filing systems for regulatory materials.
- Comply with necessary gap assessment, reporting requirements and related activities.
- Assists with certain policy language and reviewing all written materials for compliance with state and federal regulations, as well as contractual requirements.
- May interact with legal department when there are interpretation differences with clients.
- Ability to analyze, write and integrate highly technical information into action plans strongly preferred.
- Utilization management background preferred.
- Medicaid and Medicare experience preferred.
- Juris Doctor degree preferred.
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Regulatory Compliance Manager - Wallingford, United States - Elevance Health
Description
Elevance Health supports a hybrid workplace model (virtual and in-office) with PulsePoint sites used for collaboration, community, and connection.This position will take part in the hybrid workforce strategy which includes virtual work and in office days 1-2 times per week.
The Regulatory Compliance Manager is responsible for researching, analyzing, and managing regulatory mandates for a major business segment.Mandate analysis and oversight may include written guidance to ensure state and federal regulatory compliance, communications compliance and policy language development.
How You Will Make an Impact:
Primary duties may include, but are not limited to :
Minimum Requirements:
Requires a BA/BS in a related field and minimum of 5 years related regulatory compliance; or any combination of education and experience, which would provide an equivalent background.
Preferred Skills, Capabilities, and Experience:
Please be advised that Elevance Health only accepts resumes for compensation from agencies that have a signed agreement with Elevance Health.
Any unsolicited resumes, including those submitted to hiring managers, are deemed to be the property of Elevance Health.Who We Are
Elevance Health is a health company dedicated to improving lives and communities - and making healthcare simpler.
We are a Fortune 25 company with a longstanding history in the healthcare industry, looking for leaders at all levels of the organization who are passionate about making an impact on our members and the communities we serve.
How We WorkAt Elevance Health, we are creating a culture that is designed to advance our strategy but will also lead to personal and professional growth for our associates.
Our values and behaviors are the root of our culture.They are how we achieve our strategy, power our business outcomes and drive our shared success - for our consumers, our associates, our communities and our business.
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.
Elevance Health operates in a Hybrid Workforce Strategy.Unless 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. Candidates must reside within 50 miles or 1-hour commute each way of a relevant Elevance Health location.The health of our associates and communities is a top priority for Elevance Health. We require all new candidates in certain patient/member-facing roles to become vaccinated against COVID-19. If you are not vaccinated, your offer will be rescinded unless you provide an acceptable explanation. Elevance Health will also follow all relevant federal, state and local laws.
Elevance Health is an Equal Employment Opportunity employer and all qualified applicants will receive consideration for employment without regard to age, citizenship status, color, creed, disability, ethnicity, genetic information, gender (including gender identity and gender expression), marital status, national origin, race, religion, sex, sexual orientation, veteran status or any other status or condition protected by applicable federal, state, or local laws.
Applicants who require accommodation to participate in the job application process may contact assistance.#J-18808-Ljbffr
