Anthem Regulatory Oversight Analyst PS4176 in Hesperia, California
/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.
*Preferred location: *Virginia Beach, VA
Under general supervision, supports day-to-day activities of Anthem’s Medicaid business initiatives to promote corporate and health plan compliance with the regulatory/contractual obligations of multiple state and federal regulatory bodies, interacting with both internal and external contacts, including: * Coordinating regulatory reporting, collateral submission, and other required regulatory filing activities for one or more new or operational markets in support of corporate and health plan compliance with Anthem’s regulatory obligations to various state oversight agencies; or * Tracking, triaging, and managing member and provider complaints received from state regulatory agencies. Provide accurate and timely reporting and trending of complaint activity for corporate and health plan staff.
* Work in conjunction with management in supporting the day-to-day regulatory compliance activities of Anthem’s operational markets or executing strategic growth and development initiatives.
* Support research and data collection/coordination for licensure applications, readiness reviews, regulatory filings, updates to internal requirements grids, and documenting compliant activity, as applicable.
* Submit marketing/collateral filings for regulatory agency review and interacts/negotiates changes with agency contacts to gain necessary approvals, as applicable.
* Produce, analyze and maintain reports used to track the status of state regulatory agency submissions and requests (reports, complaints, etc) and associated potential risks or sanctions.
* Coordinate regulatory reporting with Anthem staff to ensure timeliness, completeness and accuracy prior to state submission, in accordance with monthly, quarterly and annual reporting timetables.
* Support the development/maintenance of departmental databases, document tracking systems, and informational resource tools (Complaint Tracking, Regulatory Alert database; Collateral Material Filing database; regulatory reporting database (DMS) etc.). * Manage the officer and director biographical affidavit preparation and filing process, as applicable:
1. Identify corporate and/or health plan business owners responsible for research, resolution and response and distribute documentation timely; 2. Review complaint responses for formatting, grammar, and content, ensuring responses adequately address the state agency issues, concerns, and/or questions. Follow-up with business owners to address responses that are incomplete,inaccurate, or missing pertinent information or documentation and request revisions; 3. Prepare state agency submissions (cover letter, complaint responses, supporting documentation, and other materials as appropriate) for review and sign-off by Regulatory Services market manager or their designee; and 4. Submit complaint responses to state agencies on or before identified due date, and coordinate any follow-up as required by the state agencies. * Interact with departments and state regulatory agencies as a positive representative of both Anthem and the Regulatory Services Department. . * Actively participate in meetings and help maintain an effective workgroup. * Perform other duties as assigned or requested.
Requires a HS Diploma or GED. Bachelor’s Degree preferred or equivalent experience in lieu of education. Also requires 1-2 years of health care, regulatory or compliance experience that includes data analysis and reporting. Or a minimum of three years of relevant work experience that included project management.
- Intermediate level Microsoft Office Suite skills.
- Intermediate level database maintenance and data query.
- Experience working with Microsoft SharePoint.
/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./
Equal Employment Opportunity Statement Anthem, Inc. will recruit, hire, train and promote persons in all job titles without regard to age, color, disability, gender (including gender identity), marital status, national origin, race, religion, sex, sexual orientation, veteran status, or other status protected by applicable law. In addition, all personnel actions such as compensation, promotion, demotion, benefits, transfers, staff reductions, terminations, reinstatement and rehire, company-sponsored training, education and tuition assistance, and social and recreational programs will be administered in accordance with the principles of equal employment opportunity.
Title: Regulatory Oversight Analyst PS4176
Requisition ID: PS4176