Job Description

Description

SHIFT: Day Job

SCHEDULE: Full-time

Your Talent. Our Vision. At Anthem, Inc., its a powerful combination, and the foundation upon which were 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 at one of America's leading health care companies and a Fortune Top 50 Company.

The Clinical Compliance Director is responsible for supporting clinical regulatory compliance for lines of businesses or a region.
Primary duties may include, but are not limited to:
Leads the coordination and collaboration to ensure compliance of delegated entities with regulatory, accrediting, and Health Plan quality of care and service requirements.
Oversees the development of tools that assist in determining exposure to regulatory and accreditation risks and identifies opportunities to manage and mitigate those risks as it relates to delegated entities.
Collaborates with teams and business management areas to develop metrics for monitoring program objectives, policies, and procedures that support regulatory and accreditation standards compliance.
Collects and maintains information related to oversight and compliance monitoring activities.
Recommends improvements or remediation to risk management, regulatory, and accreditation compliance programs for delegated entities.
Supports committee activities. Leads department projects and serves as a subject matter expert.

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.

An Equal Opportunity Employer/Disability/Veteran

Qualifications

Requires a BS/BA in health administration or a related field; 8 years of experience including 4 years of regulatory, compliance or accreditation, and auditing experience; or any combination of education and experience, which would provide an equivalent background. Knowledge of clinical regulatory requirements, state and/or federal regulatory agencies and accrediting bodies required. Knowledge of delegation oversight and compliance for delegated entities preferred. Ability to travel may be required.

Anthem, Inc. is ranked as one of Americas 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 positions.