Job Abstract

Anticipated End Date:

Position Title:

Job Description:

Oversight Compliance Consultant CA

Location: Woodland Hills, CA; Costa Mesa, CA; Walnut Creek, CA; Seattle, WA; Denver, CO & Las Vegas NV

This position will work a hybrid model (remote and office). The Ideal candidate will live within 50 miles of one of our Elevance Health PulsePoint locations above.

The Oversight Compliance Consultant CA will be responsible for serving as point of contact, coordinating and collaborating with delegated entities to ensure compliance with regulatory, accrediting and Health Plan quality of care and service requirements. Promotes and maintains favorable working partnerships and relationships with delegated entities, physicians, healthcare service providers, and internal customers to improve the delivery and quality of health care.

How you will make an impact:

• Participates in annual and ad hoc delegation oversight audits, development of corrective action plans, and analysis of required program reports and internal performance measures.

• Acts as an operational expert and interventionist through effective communication, education, and design of programs and strategies to assist delegated entities in meeting regulatory and accrediting standards, promoting quality outcomes, and maximizing resources.

• Ensures that all policies and procedures are updated as legislation or accreditation standards change.

• Assists with standardization of procedures and documentation.

• Assists in problem solving with delegated entities and internal constituents.

Minimum Requirements:

• Requires AS in nursing and minimum of 3 years of acute care, utilization management, quality management in a hospital and/or HMO setting and minimum of 2 years of experience conducting oversight audits of delegated entities and/or ancillary providers; or any combination of education and experience, which would provide an equivalent background.

• Current unrestricted RN license or LCSW in applicable state(s) required

• Travels to worksite and other locations as necessary.

Preferred Skills, Capabilities, and Experiences:

• BS in Nursing preferred.

For candidates working in person or remotely in the below locations, the salary* range for this specific position is $70,980 to $121,780.

Locations:  California, Colorado, Nevada, Washington State

In addition to your salary, Elevance Health offers benefits such as, a comprehensive benefits package, incentive and recognition programs, equity stock purchase and 401k contribution (all benefits are subject to eligibility requirements). The salary offered for this specific position is based on a number of legitimate, non-discriminatory factors set by the company.  The company is fully committed to ensuring equal pay opportunities for equal work regardless of gender, race, or any other category protected by federal, state, and local pay equity laws. 

* The salary range is the range Elevance Health in good faith believes is the range of possible compensation for this role at the time of this posting. This range may be modified in the future and actual compensation may vary from posting based on geographic location, work experience, education and/or skill level. Even within the range, the actual compensation will vary depending on the above factors as well as market/business considerations. No amount is considered to be wages or compensation until such amount is earned, vested, and determinable under the terms and conditions of the applicable policies and plans. The amount and availability of any bonus, commission, benefits, or any other form of compensation and benefits that are allocable to a particular employee remains in the Company's sole discretion unless and until paid and may be modified at the Company’s sole discretion, consistent with the law.

Job Level:

Workshift:

Job Family:

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. Candidates must reside within 50 miles or 1-hour commute each way of a relevant Elevance Health location.

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. 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 may contact elevancehealthjobssupport@elevancehealth.com for assistance.