Oversight Compliance Consultant CA

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

Elevance Health supports a hybrid workplace model with pulse point sites (major office) used for collaboration, community, and connection. This position will be primarily virtual, however will be based within 50 miles of a pulse point site listed 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.