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Company Name:
Anthem
Approximate Salary:
Not Specified
Location:
Chicago, Illinois
Country:
United States
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Regulatory Compliance Manager (Chicago, IL) 139088

Description

Your Talent. Our Vision. At AIM Specialty Health (AIM), a proud member of the Anthem, Inc. family of companies, it's a powerful combination, and the foundation upon which we're creating greater 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 located in Chicago, Illinois


The Regulatory Compliance Manager is responsible for managing regulatory compliance functions across the enterprise, including corrective action plan (CAP) monitoring/coordination and operations audit oversight.


Primary duties may include, but are not limited to:

  • Manages timely completion of all client required deliverables and responses, maintaining open communication with the client on a daily basis to keep abreast of client activities.
  • Performs and/or request required research to support client compliance activities.
  • Demonstrates understanding of compliance aspects of client contract provisions, Health Plan specific rules, governmental and agency regulations, laws, and rules associated with AIMs delegated support of client.
  • Develops, implements and maintains formal CAP and operations audit oversight structure and materials.
  • Creates the structure and processes necessary to manage internal oversight activities. Assists with internal risk assessment and accreditation activities.

About AIM Specialty Health

AIM Specialty Health (AIM) is a leading specialty benefit management company that promotes appropriate, safe and affordable healthcare services. We are a member of the Anthem family of companies, which is recognized as one of the nation's leading health benefits companies.

AIM provides innovative clinical solutions that focus on today's most complex and costly tests and treatments in radiology, cardiology, medical and radiation oncology, specialty drugs, sleep medicine, musculoskeletal and pain management, genetic testing, palliative care, and other emerging clinical areas.

With evidence-based medicine, technology, people and processes, we support clinical appropriateness review, provider collaboration and member engagement on behalf of more than 50 health plans, 40% of the Fortune 50 Employers, and 43 million members.

Today, our team includes more than 1,100 associates and features more than 600 licensed and board-certified physicians, nurses, and other healthcare professionals who engage with more than 330,000 health care providers across the country. These healthcare providers access our solutions and specialized clinical expertise through our online ProviderPortal and experienced contact center-based teams that is enabled by our business platform.

Our pioneering spirit and dedication to improve health care continues to produce significant industry-first advancements, quality recognition achievements, and high satisfaction rates. AIM is certified by the National Committee for Quality Assurance (NCQA) and has received Full Accreditation for Health Utilization Management from the Utilization Review Accreditation Commission (URAC.)

We maintain offices in Chicago, Deerfield, Schaumburg and Westchester, IL, as well as Glendale, CA.

To learn more, visit www.aimspecialtyhealth.com .

Qualifications

Requires BA/BS degree in a related field, 5-7 years related regulatory or contract compliance with ability to analyze, write and integrate highly technical information into action plans; or any combination of education and experience which would provide an equivalent background. Also requires strong interpersonal and organization skills. Previous healthcare, CAP management, regulatory and accreditation experience (URAC/NCQA) 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 antheminc.com/careers. EOE. M/F/Disability/Veteran.

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