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Oversight Compliance Consultant Senior - Elevance Health
Company | Elevance Health |
Address | New York, NY, United States |
Employment type | FULL_TIME |
Salary | |
Category | Hospitals and Health Care |
Expires | 2023-09-19 |
Posted at | 8 months ago |
Oversight Compliance Consultant Senior
- Type: Full time
- Date Posted:Aug 16, 2023
- Job Family: Medical and Clinical
- Req #: JR84974
- OH, MASON
- NC, CARY
- VA, RICHMOND
- LA, METAIRIE
- OH, CINCINNATI
- CO, DENVER
- IA, W DES MOINES
- VA, ROANOKE
- CT, WALLINGFORD
- NV, LAS VEGAS
- IN, INDIANAPOLIS
- FL, TAMPA
- NC, WINSTON
- WV, CHARLESTON
- NY, MIDDLETOWN
- VA, NORFOLK
- NE, LINCOLN
- TN, NASHVILLE
- FL, MIAMI
- MD, HANOVER
- NV, LAS VEGAS
- DC, WASHINGTON
- WI, Waukesha
- MN, GILBERT
- GA, MIDLAND
- CA, COSTA MESA
- TX, HOUSTON
- IL, CHICAGO
- CA, WOODLAND HILLS
- OH, MASON
- NY, NEW YORK
- NJ, MORRISTOWN
- ME, SOUTH PORTLAND
- MN, MENDOTA HEIGHTS
- GA, ATLANTA
- MO, ST LOUIS
- TX, GRAND PRAIRIE
- RI, SMITHFIELD
- OH, COLUMBUS
- NY, LATHAM
- CA, WALNUT CREEK
- NH, MANCHESTER
- NJ, ISELIN
- WA, SEATTLE
- KY, LOUISVILLE
- OH, SEVEN HILLS
- CA, PALO ALTO
- Develops training materials and conducts training and/or new hire orientation.
- Assists with standardization of procedures and documentation.
- Delivers timely and constructive coaching and feedback.
- Acts as an operational expert and interventionist through communication, education, and design of programs and strategies to assist delegated entities and internal departments meet regulatory and accrediting standards, promote quality outcomes, and maximize resources.
- Takes lead with healthcare industry collaborations so as to enhance regulatory and accrediting compliance among constituents.
- Ensures that all policies and procedures are updated as legislation or accreditation standards change.
- Performs annual and ad hoc delegation oversight audits and internal health plan functional unit audits.
- Assists in problem-solving with delegated entities and internal constituents.
- Develops corrective action plans and analyses of required program reports and internal performance measures.
- Assists with planning and implementation of formal education sessions to external customers to address non-compliance issues.
- BS in nursing preferred.
- Ability to learn new software systems strongly preferred.
- Desire to learn non-clinical audit functions strongly preferred.
- Travels to worksite and other locations throughout the U.S., as necessary.
- Strong knowledge of managed care principles and delivery systems, the medical management process, accreditation and regulatory standards, delegated oversight processes, and workflow systems strongly preferred.
- Utilization Management and/or Case Management experience strongly preferred.
- The salary range is the range Elevance Health in good faith believes is the range of possible compensation for this role at the time of this posting. This range may be modified in the future and actual compensation may vary from posting based on geographic location, work experience, education and/or skill level. Even within the range, the actual compensation will vary depending on the above factors as well as market/business considerations. No amount is considered to be wages or compensation until such amount is earned, vested, and determinable under the terms and conditions of the applicable policies and plans. The amount and availability of any bonus, commission, benefits, or any other form of compensation and benefits that are allocable to a particular employee remains in the Company's sole discretion unless and until paid and may be modified at the Company’s sole discretion, consistent with the law.
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