Compliance Consultant Senior

Elevance Health; Seven Hills (OH); Hybrid; USD 70,000 - 90,000; Full time

Job summary

Elevance Health is seeking a Compliance Consultant Senior to deliver strategic compliance responsibilities at the highest level within the Ohio Medicaid Market Team. This role involves serving as the main point of contact for complaints, processing inquiries, and providing senior analytical support for audits and projects. Candidates must have a BA/BS and at least 5 years of relevant experience. The position requires in-office collaboration for 1-2 days per week, offering flexibility. Join us in enhancing compliance efforts and supporting health care standards in Ohio.

Qualifications

• Minimum of 5 years health care, regulatory, ethics, compliance or privacy experience.
• Strong understanding of state regulations regarding Medicaid.

Responsibilities

• Function as point of contact for member and provider complaints.
• Process regulator inquiries and coordinate collateral submissions.
• Report, communicate, and research laws and regulatory requirements.

Skills

Proficient utilizing MS-Office

Medicaid knowledge

Education

BA/BS

Job description

Locations: This role requires associates to be in-office 1-2 days per week, fostering collaboration and connectivity while providing flexibility to support productivity and work-life balance. Please note that candidates not within a reasonable commuting distance from the posting location will not be considered for employment, unless an accommodation is granted as required by law.

PLEASE NOTE: This position is not eligible for current or future VISA sponsorship.

Compliance Consultant Senior

The Compliance Consultant Senior is responsible for delivering and executing foundational and strategic compliance responsibilities with consistent excellence that support the team and management at the most senior advanced level. This role is part of the Ohio Medicaid Market Team.

How you will make an Impact

• Function as point of contact for member and provider complaints received by the Ohio Medicaid Regulator.
• Process regulator Ad Hoc inquiries, and coordinates and tracks collateral submissions as required by the state contract.
• Additional internal responsibilities include policy reviews, regulatory grid completion and job aid development and updates.
• At the most senior advanced level, report, communicate, research laws, regulations, requirements, regulatory audits and/or exams.
• Provide senior level analytical support to projects, initiatives, regulatory audits or exams, internal audits, accreditations, on-site reviews, risk assessments.
• Utilize systems unique to job functions, including standard-issue software such as Microsoft products; maintain system documentation, serve as subject matter expert, train users of system, contribute to system design, oversight or maintenance.
• Apply critical thinking to formulate strategies and concepts that drive results, persuade and influence others, adapt to change, and manage conflict.

Minimum Requirements

Requires a BA/BS and minimum of 5 years health care, regulatory, ethics, compliance or privacy experience; or any combination of education and experience, which would provide an equivalent background. Travels to worksite and other locations as necessary.

Preferred Skills, Experiences and Competencies

• Proficient utilizing MS-Office
• Medicaid knowledge

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.