Anthem Clinical Compliance Director PS4619 in Cincinnati, Ohio

Clinical Compliance Director PS4619

Location: United States

Field: Medical

Requisition #: PS4619

Post Date: May 08, 2018

Your Talent. Our Vision. At Anthem, Inc., it’s a powerful combination, and 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 at one of America's leading health benefits companies and a Fortune Top 50 Company.

This position may be located in FL, TN or work from home.

Responsible for supporting Behavioral Health clinical regulatory compliance and Behavioral Health Parity for lines of businesses. Primary duties may include, but are not limited to: Leads the coordination and collaboration of Behavioral Health Governance Committee within the Anthem Matrix environment. Ensure’s compliance 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. 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 quality improvement and compliance monitoring activities. Recommends improvements or remediation to risk management, regulatory, and accreditation compliance programs. Supports quality committee activities. Leads department projects and serves as a subject matter expert.

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 regulatory agencies and accrediting bodies required. Ability to travel may be required. Healthcare experience required, managed care preferred. Experience with Medicare and/or Medicare Compliance is preferred.

Anthem, Inc. is ranked as one of America’sMost Admired Companies among health insurers by Fortune magazine and is a 2015DiversityInc magazine Top 50 Company for Diversity. To learn more about ourcompany and apply, please visit us at antheminc.com/careers. EOE.M/F/Disability/Veteran.