Regulatory Oversight Consultant-Tampa, FL (Ps28245)

Anthem, Inc. Tampa , FL 33602

Posted 1 week ago

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.

Regulatory Oversight Consultant

Must be able to sit onsite in Tampa, FL-5600 Mariner St.

Responsible for providing enterprise-wide reporting and oversight of federal and state regulatory implementation, compliance and exam activities. This is an experienced associate with knowledge specific to the company who can handle complex assignments or projects.

Primary duties may include, but are not limited to:

  • Ensures ongoing communication and distribution of federal rules, regulations and requirements throughout the organization.

  • Partners with business owners in order to ensure and obtain evidence to support all necessary actions are taken by regulatory due dates.

  • Oversight and management of repository that houses all organizational policies and procedures

  • Responsible for conducting regulatory research

  • Assists with Compliance Investigations

  • Conducts audit and monitoring compliance activities

  • Assigned compliance projects as required to meet departmental and organizational deadlines.

  • This position provides critical support to the Compliance Department

  • Communicates state and federal laws and regulations throughout the company; assists with the identification of business owners to lead implementation efforts and subject matter experts to participate on project teams; and provides enterprise-wide reporting on implementation status and compliance concerns.

  • Provides guidance to and works collaboratively with area leaders to identify and implement improvements in the company's regulatory process.

  • Obtains and maintains an awareness of industry regulatory trends, organizational developments, and company strategies that could impact the success of regulatory projects.

  • Extracts, analyzes, and reports regulatory data develops and produces standard, customized and ad-hoc reports.

  • Performs administrative duties related to the company's regulatory database.

  • Maintains knowledge of database design, data definitions, system capabilities, and data integrity issues. Develops and/or modifies requirements, business design specifications, user training and documentation.

Qualifications:

  • Requires a BA/BS degree, 3-5 years of responsible and effective regulatory or compliance related experience in healthcare or managed care industry that includes data analysis, reporting, research, problem-solving and project management experience; or any combination of education and experience, which would provide an equivalent background.

  • Medicare experience is required

  • Experience with compliance and regulatory duties is an asset

  • Coding experience is required

  • Claims processing background is required

  • Detailed oriented organizational skills is required

  • Investigative skills is an asset

  • Must be able to sit onsite in Tampa, FL (5600 Mariner St.)

Anthem, Inc. is ranked as one of America's Most Admired Companies among health insurers by Fortune magazine and is a 2018 DiversityInc magazine Top 50 Company for Diversity. To learn more about our company and apply, please visit us at careers.antheminc.com. An Equal Opportunity Employer/Disability/Veteran.


icon no score

See how you match
to the job

Find your dream job anywhere
with the LiveCareer app.
Mobile App Icon
Download the
LiveCareer app and find
your dream job anywhere
App Store Icon Google Play Icon
lc_ad

Boost your job search productivity with our
free Chrome Extension!

lc_apply_tool GET EXTENSION

Similar Jobs

Want to see jobs matched to your resume? Upload One Now! Remove
Registered Dietitian RD Nutrition Support Tampa FL

CVS Health

Posted 2 days ago

VIEW JOBS 3/27/2020 12:00:00 AM 2020-06-25T00:00 Job Description As a Nutrition Support Dietitian with Coram/CVS specialty infusion services, you will utilize use your clinical nutrition experiences, along with patient education and relationship development to support patients receiving specialized complex therapy infusion services. You'll use your excellent written and verbal customer service skills in order to interact with key partners and patients. You'll play an instrumental role in making a real difference by improving the quality of life for patients in need. Your Nutrition Support responsibilities will be to - * Evaluate parenteral and dual therapy patient (TPN and Tube feeding) prescriptions including formula (macro and micronutrients), volume, administration and other parameters based on specific patient needs. * Provide ongoing monitoring, assessments and recommend therapeutic interventions as appropriate. Prepare written communication of follow-up nutrition care in the medical record and communicate findings to the physician and other pertinent care givers. * Assist in the qualification and documentation of medical necessity for all payors for parenteral nutrition therapies to secure reimbursement for home parenteral nutrition. * Coordinate the clinical plan of care with branch team. Collaborate with the clinical department managers to educate internal staff on appropriate nutrition therapy, nutrition policies and procedures and reimbursement related topics. * Lead/participate in nutrition support team meetings/patient care conferences and contribute appropriate clinical information. * Provide patient and care giver instruction related to nutrition therapy and oral diet at home as ordered by the physician. * Partner with sales to identify potential growth opportunities for home parenteral nutrition. Develop and maintain nutrition customer relationships. Serve as a content expert for sales support activities which may include providing continuing education programs. In this full time position which includes company benefits, you'll be working in our Tampa branch. During the current health crisis you'll be working remotely from home. Registered Dietitians with Coram CVS/specialty infusion services have a uniquely rewarding setting to use their exceptional nutritional skills. As a national leader in the home infusion/tube feeding field, those specialized dietitians will not only possess strong clinical acumen but the kind of deep compassion and sensitivity it takes to build one-on-one relationships and support patients receiving parenteral nutrition therapy in the comfort of their home. Learn more about us: https://www.youtube.com/user/CoramHealthcare Required Qualifications * Current registration by the Commission of Dietetic Registration of the American Dietetic Association. * Registered Dietitian with current license in state of employment. Additional licensure may be required in multi-state service areas. * Minimum 2 years' experience with parenteral nutrition, TPN and tube feeding. * Computer proficiency in Word, Power Point, Excel. * Advanced certification in the area of nutrition support (Certified Nutrition Support Clinician) upon hire or completed within first year of employment. Preferred Qualifications * TPN/home infusion experience * Electronic medical record experience * A.S.P.E.N membership * CNSC certification Education Bachelor's degree in Food/Nutrition or Dietetics is required. Business Overview It's a new day in health care. Combining CVS Health and Aetna was a transformative moment for our company and our industry, establishing CVS Health as the nation's premier health innovation company. Through our health services, insurance plans and community pharmacists, we're pioneering a bold new approach to total health. Coram CVS/specialty infusion services is a leading national provider of specialty home infusion and specialty pharmacy services providing infusion therapies and services to over 20,000 patients each month. We offer a diverse work experience that empowers colleagues for career success. In addition to skill and experience, we also seek to attract and retain colleagues whose beliefs and behaviors are in alignment with our core values of collaboration, innovation, caring, integrity and accountability. CVS Health is an equal opportunity/affirmative action employer. Gender/Ethnicity/Disability/Protected Veteran - we highly value and are committed to all forms of diversity in the workplace. We proudly support and encourage people with military experience (active, veterans, reservists and National Guard) as well as military spouses to apply for CVS Health job opportunities. We comply with the laws and regulations set forth in the following EEO is the Law Poster: EEO IS THE LAW and EEO IS THE LAW SUPPLEMENT. We provide reasonable accommodations to qualified individuals with disabilities. If you require assistance to apply for this job, please contact our Advice and Counsel Reasonable Accommodations team. Please note that we only accept applications for employment via this site. If technical issues are preventing you from applying to a position, contact Kenexa Helpdesk at 1-855-338-5609 or cvshealthsupport@us.ibm.com. For technical issues with the Virtual Job Tryout assessment, contact the Shaker Help Desk at 1-877-987-5352. CVS Health Tampa FL

Regulatory Oversight Consultant-Tampa, FL (Ps28245)

Anthem, Inc.