- 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).
- Travels to worksite and other locations as necessary.
- Coordinate with key stakeholders, including but not limited to business partners, legal, privacy, information security to manage inquiries and incidents related to anti-trust, firewall to ensure guidance provided and/or corrective actions identified and completed, as necessary
- Establish and maintain tracking of firewall inquiries and incidents across Carelon to assist with audits and investigations
- Incorporate inquiries and incidents into ECP risk assessment process to identify key risk areas
- Organize regular audits and risk assessments to identify potential vulnerabilities and determine the efficacy of existing controls.
- Adopt best practices and strategic initiatives to improve firewall management activities to protect corporate interests and ensure business transparency and fairness.
- Coordinate and support enterprise and enhanced training creation and distribution, as needed, to educate employees about anti-trust regulations, corporate policies and the role of the firewall enforcing these.
- 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.
- Strong leadership/managerial skills and ability to motivate/coach other staff strongly preferred.
- MS/MBA/JD or professional designation preferred.
- Experience in the design and management of anti-trust firewall regulations in an enterprise setting.
- Excellent interpersonal and communication skills.
- Strong analytical and problem-solving skills.
- Ability to work with cross-functional teams.
- Proficient in risk management and audit processes.
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Compliance Director - Richmond, United States - Elevance Health
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Description
Compliance DirectorLocation:
Richmond, VA.
Open to other Pulse Point locations, must be within a 50 mile radius of a Pulse Point location.
This position will take part in Elevance Health's hybrid workforce strategy which includes virtual work and 1-2 days in office per week.
The Compliance Director is responsible for directing foundational and strategic compliance responsibilities with consistent excellence that support the 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:
Minimum Requirements:
Preferred Skills, Capabilities, and Experiences:
Please be advised that Elevance Health only accepts resumes for compensation from agencies that have a signed agreement with 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 Work
At 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.
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.
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.