SHIFT: Day Job
Your Talent. Our Vision. At CareMore, a proud member of the
Anthem, Inc. family of companies specializing in providing senior
Americans a complete and pro-active health care experience, it's a
powerful combination. It's the foundation upon which we're creating
greater access to care for our members, greater value for our
customers and greater health for our communities. Join us and
together we will drive the future of health care.
This is an exceptional opportunity to do innovative work that
means more to you and those we serve.
This position is open to remote in a PST geographical area with
Cerritos, CA preferred.
Responsible for managing foundational and strategic compliance
responsibilities with consistent excellence that support the team
Primary duties for this managing level position, with moderate
to advanced complexity and broad/enterprise scale may include, but
are not limited to:
+ Manage/oversee projects, 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
+ Establish project plans, gap analysis, milestone dates, and
other significant aspects, and leadership updates.
+ Maintain knowledge of laws, regulations, company strategies to
assess impact, and consult with clients as subject matter
+ Conducts complex investigations, document findings, and ensure
corrective actions are made.
+ Interface with external clients, regulators, vendors,
supplier; internal stakeholders, high level of management.
+ Requires a BA/BS; MS/MBA/JD or professional designation
preferred; at least 6+ years of health care, regulatory, ethics,
compliance or privacy experience; or any combination of education
and experience, which would provide an equivalent background.
+ Ability to travel may be required.
+ Experience supporting Claims during CMS Program Audits of
Medicare Advantage Plans is strongly preferred for this role.
+ Thorough understanding of Medicare guidelines and reporting
requirements for Claims in a Medicare Advantage Plan/MSO
+ Excellent verbal and written communication skills
+ Ability to present across all levels of the business from
colleagues to executive business leaders.
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.
Anthem, Inc. is ranked as one of America's Most Admired Companies
among health insurers by Fortune magazine and has been named a 2019
Best Employers for Diversity by Forbes. To learn more about our
company and apply, please visit us at careers.antheminc.com. An
Equal Opportunity Employer/Disability/Veteran. Anthem promotes the
delivery of services in a culturally competent manner and considers
cultural competency when evaluating applicants for all Anthem