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Regulatory Oversight Consultant

  • Job Family: Fraud
  • Type: Full time
  • Date Posted:
  • Req #: JR41349

Location:

  • FL, Tampa
  • Florida, Florida

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Description

Location : State of Florida. Tampa or Miami, FL highly preferred.

How you will make an impact:

The Regulatory Oversight Consultant is responsible for providing enterprise-wide reporting and oversight of federal and state regulatory implementation, compliance and exam activities.  This is an experienced associate with specific regulatory knowledge, while managing complex assignments or projects. Primary duties may include, but are not limited to:

  • Communicates state and federal laws and regulations throughout the company; assists with the identification of business owners to lead implementation efforts and subject matter experts to participate on project teams; and provides enterprise-wide reporting on implementation status and compliance concerns.
  • Provides oversight of the regulatory process by supporting and providing expertise and monitoring the development of implementation plans, gap analysis, milestone dates, and other significant aspects.
  • Provides guidance to and works collaboratively with operational areas to identify and implement improvements in the company's regulatory process.
  • Obtains and maintains an awareness of industry regulatory trends, organizational developments, and company strategies that could impact the success of regulatory projects.
  • Extracts, analyzes, and reports regulatory data develops and produces standard, customized and ad-hoc reports and enhances reporting functionality.
  • Serves as a database subject matter expert and performs administrative duties related to the company's regulatory database.
  • Maintains knowledge of database design, data definitions, system capabilities, and data integrity issues.
  • Develops and/or modifies requirements, business design specifications, user training and documentation.
  • Researches and documents business issues, translates business requirements to technical staff/vendor to ensure that requirements are incorporated into system design.
  • Tests and documents solutions while serving as the liaison between users of the tool and technical staff/vendor.

Minimum Requirements: Requires a BA/BS and minimum of 3 years regulatory or compliance related experience in healthcare or managed care industry; or any combination of education and experience, which would provide an equivalent background.  

Preferred Skills, Capabilities, and Experiences: Ability to travel may be required. Experience with data analysis, reporting, research, problem-solving and project management experience strongly preferred. Medicare/Medicaid Experience preferred, Compliance Monitoring and Oversight Experience preferred. Strong Written and Verbal Communication Skills preferred. Strong Critical Thinking and Analytical Skills preferred.


Please be advised that Elevance Health only accepts resumes from agencies that have a signed agreement with Elevance Health. Accordingly, Elevance Health is not obligated to pay referral fees to any agency that is not a party to an agreement with Elevance Health. Thus, any unsolicited resumes, including those submitted to hiring managers, are deemed to be the property of Elevance Health.

Be part of an Extraordinary Team

Elevance Health is a health company dedicated to improving lives and communities – and making healthcare simpler. Previously known as Anthem, Inc., we have evolved into a company focused on whole health and updated our name to better reflect the direction the company is heading.

We are looking for leaders at all levels of the organization who are passionate about making an impact on our members and the communities we serve. You will thrive in a complex and collaborative environment where you take action and ownership to solve problems and lead change. Do you want to be part of a larger purpose and an evolving, high-performance culture that empowers you to make an impact?

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 to become vaccinated against COVID-19. If you are not vaccinated, your offer will be rescinded unless you provide – and Elevance Health approves – a valid religious or medical explanation as to why you are not able to get vaccinated that Elevance Health is able to reasonably accommodate. Elevance Health will also follow all relevant federal, state and local laws.

Elevance Health has been named as a Fortune Great Place To Work in 2021, is ranked as one of the 2021 World’s Most Admired Companies among health insurers by Fortune magazine, and a Top 20 Fortune 500 Companies on Diversity and Inclusion. To learn more about our company and apply, please visit us at careers.ElevanceHealth.com. 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 ability@icareerhelp.com for assistance.

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