This job board retrieves part of its jobs from: Toronto Jobs | Emplois Montréal | IT Jobs Canada

The Land of Lincoln is hiring! New job offers every day

To post a job, login or create an account |  Post a Job

Specialist, Operational Compliance

Evolent Health

This is a Full-time position in Chicago, IL posted February 19, 2021.

**It’s Time For A Change…****Your Future Evolves Here**Evolent Health has a bold mission to change the health of the nation by changing the way health care is delivered.

Our pursuit of this mission is the driving power that brings us to work each day.

We believe in embracing new ideas, testing ourselves and failing forward.

We respect and celebrate individual talents and team wins.

We have fun while working hard and Evolenteers often make a difference in everything from scrubs to jeans.Are we growing?

Absolutely.

We have seen about 30% average growth over the last three years.

Are we recognized?

Definitely.

We were named one of “Becker’s 150 Great Places to Work in Healthcare” in 2016, 2017, 2018 and 2019 and are proud to be recognized as a leader in driving important Diversity and Inclusion (D&I) efforts: Evolentachieveda 95% score on its first-ever submission to the Human Rights Campaign’s Corporate Equality Index; was named on the Best Companies for Women to Advance List 2020 by Parity.org; and we publish an annualDiversity and Inclusion Annual Report toshare our progress on how we’re building an equitable workplace.

We recognize employees that live our values, give back to our communities each year, and are champions for bringing our whole selves to work each day.

If you’re looking for a place where your work can be personally and professionally rewarding, don’t just join a company with a mission.

Join a mission with a company behind it.**Who You’ll Be Working With:**Evolent Health is looking for an Operational Compliance Specialist to be a key member of our Medicare Advantage Operations team.

As a critical team member this individual is responsible for collecting, reviewing and tracking follow-up items / resolution on key compliance activities and issues in support of EVHs Health Plan Partners.**What You’ll Be Doing:**+ Reviews newly enacted legislation, regulations, sub-regulatory guidance and instructions to determine impact on Evolent and delegated entities.+ Conducts meetings and discussions with Evolent clients to provide updates related to the status of HPMS Memos and other regulatory or sub-regulatory guidance.+ Supports and coordinates day-to-day compliance with Medicare requirements+ Performs ongoing monitoring of all MA functional areas including but not limited to Enrollment, Claims, Appeals and Grievances, and Call Center+ Assists in the development of an annual monitoring workplan+ Conducts regulatory research for senior members of the Medicare Compliance and Medicare Operations teams+ Works closely with other members of the Compliance and Medicare Operations Teams to help resolve compliance issues+ Serve on various committees, participate in designated cross department work group and attends required meetings+ Ability to accommodate and work within central time zone, ideally between 7am and 6pm CT.+ Perform other duties and projects as assigned.**The Experience You’ll Need (Required):**+ Bachelor’s Degree or equivalent+ 2-4 years of professional experience in Medicare Compliance or Medicare Operations for a Managed Care Health Plan or Health Plan administration organization**Finishing Touches (Preferred):**+ 3-5 years of professional experience in Medicare Compliance or Medicare Operations for a Managed Care Health Plan or Health Plan administration organization+ Deep understanding of Medicare Advantage regulations and guidance including, but not limited to the Medicare Managed Care Manual and the Medicare Prescription Drug Benefit manual+ Experience participating in and coordinating CMS Program Audits+ Excellent written and oral communication+ Ability to prioritize and manage simultaneous projects without supervision+ Collaborative working style+ Comfortable working in an extremely dynamic environment+ Strong sense of ethics+ Experience with operations, service and process engineering implementations+ Entrepreneurial mindset geared toward the creation, execution and continuous improvement of health plan operations and implementations+ Demonstrated exceptional active listening and communications skills**Technical requirements:**Currently, Evolent employees work remotely temporarily due to COVID-19.

As such, we require that all employees have the following technical capability at their home: High speed internet over 10 MBPS and, specifically for all call center employees, the ability to plug in directly to the home internet router.

These at-home technical requirements are subject to change with any scheduled reopening of our office locations.**Evolent Health is an equal opportunity employer and considers all qualified applicants equally without regard to race, color, religion, sex, sexual orientation, gender identity, national origin, veteran status, or disability status.**