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Medicaid Compliance Dir-Plan (TX) - PS9438 in Caldwell, ID at Anthem, Inc.

Date Posted: 7/10/2018

Job Snapshot

  • Employee Type:
  • Location:
    Caldwell, ID
  • Job Type:
  • Experience:
    At least 7 year(s)
  • Date Posted:

Job Description

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.

Location: Austin, Texas preferred 

The Medicaid Compliance Director is responsible for implementing and maintaining the Medicaid Business Unit (MBU) Compliance Program, incorporating the Office of Inspector General's Guidance on the essential components of an effective compliance program that serves, in part, to prevent and detect crime, to implement effective policies and procedures, to mitigate compliance risk, to establish an auditing and monitoring program and to uphold an ethical culture.

Primary duties may include but are not limited to: 
  • Develops and implements an annual plan-specific compliance work plan to ensure the elements of an effective compliance program are appropriately in place at the plan-level and that the MBU compliance work plan is carried out locally, as appropriate. 
  • Participates as an active member of the health plan's leadership team, developing strong relationships with key leaders and engaging plan leadership in the compliance risk assessment process to identify and address compliance risks and failures and manage action plans designed to fully mitigate risk(s).  
  • Delivers compliance education sessions to address key issues. 
  • Monitors adherence to contractual and regulatory obligations. 
  • Designs and implements a compliance communication strategy to keep senior management and other relevant associates informed of changes to the regulatory environment, as well as communicating about specific compliance program initiatives throughout the year.  
  • Manages oversight of State agency audits and other external audits

Requires BA/BS; 7+ years relevant experience compliance or audit, including 3 years of leadership/management experience; or any combination of education and experience, which would provide an equivalent background.  Master’s Degree preferred. Experience coordinating audit activities strongly preferred.

Anthem, Inc. is ranked as one of America’s Most Admired Companies among health insurers by Fortune magazine and is a 2017 DiversityInc magazine Top 50 Company for Diversity. To learn more about our company and apply, please visit us at EOE. M/F/Disability/Veteran.