Compliance Consultant -KanCare

Location : Candidates must reside within 50 miles or 1-hour commute each way of any open access Elevance Health 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.

Position Overview:

The Compliance Consultant is responsible for delivering and executing foundational compliance responsibilities that support the team and management at the advanced level.

How You Will Make an Impact :

1. Ensure Elevance Health is consistently meeting the reporting requirements stipulated under State regulatory bodies.
2. Identify newly introduced or modified reporting prerequisites.
3. Communicate details of report specifications, including timelines for reporting, formatting preferences, and required components.
4. Coordinate across health plans, product lines, and corporate business areas to define report accountability and responsibilities.
5. Submit reports to regulatory agencies on time.
6. Provide problem-solving support and guidance for report issue resolution.
7. Maintain reporting technologies to ensure efficient report metric tracking.
8. Build strong partnerships within the Elevance Health organization to facilitate accomplishment of position responsibilities and goals.
9. Understand contracts, research regulations, and comprehend report submission requirements at a moderate level.
10. Provide high-level support as the subject matter expert in regulatory reporting for audits, accreditations, on-site reviews, and risk assessments.
11. Collaborate and support analysis and review of reporting information for compliance within a matrix environment.
12. Participate in Compliance Committee meetings to communicate findings and mitigate potential risks.
13. Apply effective oversight to identify process gaps, ensure compliance, document reporting processes, and support remedial actions for delinquent and/or inaccurate reporting.
14. Conduct investigations, document findings, and ensure stakeholders and leadership are updated on reporting developments and issues.

Minimum Requirements :

Requires a BA/BS and a minimum of 3 years health care, regulatory, ethics, compliance, or privacy experience; or any combination of education and experience that would provide an equivalent background.

Preferred Skills, Capabilities, and Experiences :

1. Proficiency in Microsoft Office Suite (Word, Excel, and PowerPoint) is highly preferred.
2. Experience in working with databases.
3. Working knowledge of managed care and an ability to comprehend contracts, laws, and legislation will be advantageous.
4. Strong verbal and written communication skills.
5. The ability to communicate effectively across all levels of the business is essential.

Job Level : Non-Management Exempt

Workshift :

Job Family : FRD > Compliance

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 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. 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.

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 for assistance.