Anthem PBM Compliance Manager (PS17315) in Danville, Virginia

PBM Compliance Manager (PS17315)

Location: United States

Field: Fraud

Requisition #: PS17315

Post Date: Feb 08, 2019

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 atone of America's leading health benefits companies and a Fortune Top 50 Company.

Responsible for coordinating compliance activities and initiatives across the PBM and the enterprise by maintaining department approved regulatory and legislative compliance plan and implementing effective internal controls.

Primary duties may include, but are not limited to:

  • Identifies, monitors, revises and tracks business unit processes and implementing procedures to ensure compliance with all related measures.

  • Identifies potential risks associated with PBM activities and ensures procedures are in place to minimize risks.

  • Partners with business units to ensure compliance with all statutory and regulatory requirements.

  • Participates as compliance subject matter expert on all mandated projects; achieves business operational compliance with all related measures relative to HIPAA and SOX and Privacy and Security Office initiatives.

  • Conducts, directs, leads and facilitates all activities related to Internal and External (Regulatory and Client) audits and responds to findings.

  • Performs high level regulatory research, develops strategic plans and pro-actively anticipates business needs and requirements.

  • Develops and implements training and communication plans; manages and leads scheduled and ad-hoc compliance projects; provides and delivers compliance consultation services to the business unit.

Qualifications:

  • Requires BA/BS, 6-10 years experience

  • Or any combination of education and experience, which would provide an equivalent background.

  • Up to 25% travel required nationwide.

Assets:

  • MS/MBA or field related professional designation preferred.

  • Government Business, Medicaid, PBM, or Pharmacy knowledge preferred.

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.