Behavioral Health Compliance Senior Consultant (Compliance Consultant Senior)

Anticipated End Date:

Position Title:

Job Description:

Behavioral Health Compliance Senior Consultant (Compliance Consultant Senior)

Location: This role requires associates to be in-office 1 - 2 days per week, fostering collaboration and connectivity, while providing flexibility to support productivity and work-life balance. This approach combines structured office engagement with the autonomy of virtual work, promoting a dynamic and adaptable workplace.  Ideal candidates will be able to report to one of our Pulse Point locations in Indianapolis, IN or Grand Prairie, TX.

Please note that per our policy on hybrid/virtual work, candidates not within a reasonable commuting distance from the posting location(s) will not be considered for employment, unless an accommodation is granted as required by law.

The Behavioral Health Compliance Senior Consultant (Compliance Consultant Senior) supports compliance activities across behavioral health operations through regulatory research, audit coordination, issue management,  compliance monitoring, and compliance consultation. The role partners with business stakeholders to identify compliance requirements, facilitate remediation activities, support audit readiness efforts, and promote adherence to applicable federal and state regulations, contractual obligations, accreditation standards, and organizational policies.

How you will make an impact:

• Provide senior level analytical support to projects, initiatives, regulatory audits or exams, internal audits, risk assessments.

• Apply critical thinking to formulate strategies and concepts that drive results, persuade and influence others, adapt to change, and manage conflict.

• Support behavioral health compliance by researching and interpreting federal and state regulations, contractual requirements, and accreditation standards, while providing compliance guidance and recommendations to business stakeholders.

• Coordinate compliance audits and reviews by managing regulatory examinations, delegated entity audits, document collection, evidence tracking, audit readiness, and remediation efforts.

• Manage compliance issues and risk mitigation by investigating compliance concerns, tracking corrective action plans, performing root cause analysis, monitoring issue resolution, and escalating significant risks as appropriate.

• Collaborate across the organization to support compliance initiatives, build stakeholder relationships, facilitate cross-functional projects, improve compliance processes, and contribute to organizational readiness and operational effectiveness.

Minimum Requirements:

Requires a BA/BS and minimum of 5 years health care, regulatory, ethics, compliance or privacy experience; or any combination of education and experience, which would provide an equivalent background. Travels to worksite and other locations as necessary.

Preferred Skills Capabilities and Experiences:

• Minimum of 4 years of experience in healthcare compliance, regulatory affairs, audit, risk management, or a related field highly preferred.

• Experience supporting behavioral health, managed care, Medicare, Medicaid, or health plan operations highly preferred.

• Experience conducting regulatory research, compliance analysis, and interpreting federal and state healthcare regulations highly preferred.

• Experience supporting audits, examinations, investigations, issue management, or remediation activities highly preferred.

• Knowledge of NCQA, CMS, Medicaid, Medicare, and behavioral health regulatory requirements highly preferred.

• Strong written, verbal, analytical, and organizational skills preferred.

• Ability to manage multiple priorities and deadlines in a fast-paced environment preferred.

• Proficiency with Microsoft Office applications, including Word, Excel, PowerPoint, and Teams preferred.

• Experience with ServiceNow or other compliance, audit, or issue management systems preferred.

• Certified in Healthcare Compliance (CHC) or other relevant compliance certification highly preferred.

Job Level:

Workshift:

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Please be advised that Elevance Health only accepts resumes for compensation from agencies that have a signed agreement with Elevance Health. Any unsolicited resumes, including those submitted to hiring managers, are deemed to be the property of Elevance Health.

Who We Are

Elevance Health is a health company dedicated to improving lives and communities – and making healthcare simpler. We are a Fortune 25 company with a longstanding history in the healthcare industry, looking for leaders at all levels of the organization who are passionate about making an impact on our members and the communities we serve.

How We Work

At Elevance Health, we are creating a culture that is designed to advance our strategy but will also lead to personal and professional growth for our associates. Our values and behaviors are the root of our culture. They are how we achieve our strategy, power our business outcomes and drive our shared success - for our consumers, our associates, our communities and our business.

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.

Elevance Health operates in a Hybrid Workforce Strategy. Unless specified as primarily virtual by the hiring manager, associates are required to work at an Elevance Health location at least once per week, and potentially several times per week. Specific requirements and expectations for time onsite will be discussed as part of the hiring process.

The health of our associates and communities is a top priority for Elevance Health. We require all new candidates in certain patient/member-facing roles to become vaccinated against COVID-19 and Influenza. If you are not vaccinated, your offer will be rescinded unless you provide an acceptable explanation. Elevance Health will also follow all relevant federal, state and local laws.

Elevance Health is an Equal Employment Opportunity employer, and all qualified applicants will receive consideration for employment without regard to age, citizenship status, color, creed, disability, ethnicity, genetic information, gender (including gender identity and gender expression), marital status, national origin, race, religion, sex, sexual orientation, veteran status or any other status or condition protected by applicable federal, state, or local laws. Applicants who require accommodation to participate in the job application process should submit the following form: Accessibility Accommodation Request Form and a member of the team will be in contact. Qualified applicants with arrest or conviction records will be considered for employment in accordance with all federal, state, and local laws, including, but not limited to, the Los Angeles County Fair Chance Ordinance and the California Fair Chance Act.

Prospective employees required to be screened under Florida law should review the education and awareness resources at HB531 | Florida Agency for Health Care Administration.

NOTE: Workday keeps job postings active through 11:59:59 PM on the day before the listed end date. Example: If the end date is 3/13, the posting will automatically come down on 3/12 at 11:59:59 PM. In other words — the job is posted until 3/13, not through 3/13.