🌎
This job posting isn't available in all website languages

Settings

VP Compliance - Commercial and Specialty Business (PS14376)

📁
Executive
📅
PS14376 Requisition #
Apply for Job
Share this Job
Sign Up for Job Alerts

 

Anthem is a Fortune 30 company and a leading health benefit company, with operating revenue of over $85 billion and over $60 billion in assets.  Anthem serves over 40 million medical members, or one in every nine Americans.   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. 

 
 
POSITION OVERVIEW
 

This position establishes control points and adherence to all state health insurance and CMS exchange regulations while optimizing Anthem’s professional relationships with CMS and other key stakeholders. This position reports to Anthem’s Chief Compliance Officer.   Anthem’s Commercial and Specialty businesses generate several billion dollars in revenue annually and helps provide valuable medical and specialty coverage to millions of individuals, groups and employers.  As a critical partner in health care delivery, the risks of Anthem failing to maintain compliance could result in fines, sanctions and/or termination of Anthem’s contracts and licenses.  In addition, such fines, sanctions and penalties could impair Anthem’s ability to participate in other federal and state funded programs.  

 
 

Key to success in this role, the ideal candidate will:

  • Implement the Commercial and Specialty Compliance Programs.  The Commercial and Specialty Compliance Officer is accountable for defining the Commercial and Specialty Compliance Program structure, educational requirements, reporting, and complaint mechanisms, proactive monitoring and mitigation of risk, response and correction procedures, and compliance expectations of all personnel and vendors supporting Anthem’s Commercial and Specialty businesses (including life, disability, vision, dental).
  • Ensure compliance reports are provided regularly (at least quarterly) to the

Anthem Board or sub-committee of the Board (i.e., Audit Committee), divisional Presidents overseeing Commercial and Specialty, and the Commercial and Specialty Compliance Committee.  Reports should include the status of Anthem’s Commercial and Specialty compliance program implementation/effectiveness, the identification and resolution of suspected, detected or reported instances of noncompliance, and Anthem’s compliance oversight and audit activities; the Commercial and Specialty Compliance Officer shall have express authority to provide unfiltered reports to Anthem’s Chief Compliance Officer and/or senior leadership.

  • Be accountable for managing and coordinating Anthem’s interactions with CMS. The Commercial and Specialty Compliance Officer is also responsible for responding to and documenting responses to CMS inquiries
  • Be aware of daily business activity by interacting with the operational units of Anthem and Applicable vendors
  • Create and coordinate, by appropriate delegation if desired, educational training programs to ensure that applicable Anthem governing body, managers, employees, vendors, and other individuals working/supporting Commercial and Specialty businesses are knowledgeable about Anthem’s compliance program, its written Standards of Conduct, compliance policies and procedures, and all applicable statutory and regulatory requirements
  • Develop and implement methods and programs that encourage managers, employees, and vendors to report noncompliance and potential FWA without fear of retaliation
  • Maintain and/or have access to applicable compliance reporting mechanism and closely coordinating with the Internal Audit Department and the SIU
  • Support and ensure that appropriate support and actions are provided to reports of potential FWA, and the development of appropriate corrective or disciplinary actions, if necessary. To that end, the Commercial and Specialty Compliance Officer should have the flexibility to design and coordinate internal investigations.
  • Ensure the appropriate documentation is maintained for each report of potential noncompliance or potential FWA received from any source, through any reporting method (e.g., hotline, mail, or in-person)
  • Oversee the development and monitoring of the implementation of corrective action plans
  • Interview or delegate the responsibility to interview Anthem’s employees, vendors and other relevant individuals regarding compliance issues
  • Review company contracts and other documents pertinent to the Commercial and Specialty business Review or delegate the responsibility to review the submission of data to

CMS to ensure that it is accurate and in compliance with CMS reporting requirements;

  • Conduct and/or direct audits or monitoring of any area or function involved with Anthem’s Commercial and Specialty business; and
  • Recommend policy, procedure, and process changes
 
CRITICAL SUCCESS FACTORS
 
Communication and Influence
  • Ask tough questions, challenge and engage leaders in conversation to ensure the right things happen for the business Active engagement with leaders to ensure solid understanding of the business
  • Help leaders understand business implications of actions, influencing a change in direction as needed
  • Integrate key messages into all communications to ensure people understand how initiatives work together to support business goals
  • Has the executive presence to influence direction and inspire confidence with Anthem’s senior leaders
 
Visionary Thinking
  • Establish strategies that create or sustain competitive advantage 
  • Think broadly and long-term, recognizing the impact of decisions and actions on Anthem’s, business and key stakeholders
 
Focus your people
  • Create an environment that enables and focuses people on the company’s mission,  vision and strategy
  • Inspire superior performance by cultivating ownership and personal commitment to goals and objectives
  • Communicate strategic context to ensure people understand what we are doing and what drives them
  • Discontinue efforts not focused on critical business priorities
 
Executing for Results
  • Hold oneself to the highest standards of accountability; has the ability to drive change while maintaining operating effectiveness; integrates and aligns efforts across functions; monitors results; tackles problems directly and delegates effectively.
 

Direct Reports: 8 indirect reports: 70


 

 

 

 

 

 PROFESSIONAL QUALIFICATIONS
  • Bachelor's degree in a related field (Master's preferred)
  • Minimum of 10-15+ years of experience in large, corporate healthcare
  • Demonstrated experience managing an enterprise-wide relationship with regulators and senior leaders
  • Minimum of 8 years of experience managing a compliance or governance function in a complex health care environment
  • Demonstrated successful   leadership skills in program management, program execution, and people management 
  • Strong analytic skill set to identify and prioritize strategies and initiatives for growth
  • Ability to plan, organize, administer, and coordinate a variety of large and complex services, projects, and programs
  • Successful leadership and management experience building effective teams, managing cross functional teams, and continuous improvement/staff development programs
  • Demonstrated superior oral/written interpersonal communication, persuasion, and negotiation skills
  • Strategic thinking and demonstrated organizational leadership capabilities required
  • Innovation and creativity, teamwork and communications
  • Ability to successfully interface at all levels with the customer, industry, and corporate entities

*Position located in one of Anthem’s nationwide offices, with expected nationwide travel.

  

 Anthem, Inc. is ranked as one of America’s Most Admired Companies among health insurers by Fortune magazine and is a 2017 DiversityInc magazine Top 50 Company for Diversity. To learn more about our company and apply, please visit us at antheminc.com/careers. EOE. M/F/Disability/Veteran.

 
 
 
 

My Profile

Create and manage profiles for future opportunities.

Go to Profile

My Submissions

Track your opportunities.

My Submissions

Similar Listings

United States

📁 Executive

Requisition #: PS14375

Career Areas

At Anthem, Inc., there are many ways to make a difference. Here, the skills and passions of thousands come together, creating an impressive force with the power to change lives and the future of health care.

 

Actuarial

Contribute to analysis that impacts the financial future and well-being of our stakeholders, customers and the health care industry.

Read More

Find a Career

Administrative and
 Business Support

Use your exceptional organizational and interpersonal skills to help ensure the consistent, quality-driven performance of a consumer-centric industry leader.

Read More

Administrative Careers

Business Support Careers

 
 

Business Development and Sales

Be the embodiment of our "Easy-to-do Business With" Value, by treating our customers the way you would want to be treated and providing simple solutions that are easy to understand.

Read More

Business Development Careers

Sales Careers

Communications and Marketing

Lead the development of new messaging, products and innovations that continuously improve the value of our offerings to customers.

Read More

Communications Careers

Marketing Careers

 
 

Customer Care

Become the ultimate customer advocate. Share your expertise and help customers maximize the value of the tools and resources we provide.

Read More

Find a Career

Digital Transformation and Enablement

If you are eager to develop innovative digital products in healthcare and make a difference in people's lives, join our Digital organization and help us change the face of healthcare together.

Read More

Digital Solutions Careers

Digital Technologies Careers

 
 

Finance

Bolster the strategic objectives of a Fortune 50 industry leader, while supporting the tenet of financial integrity that is fundamental to Anthem, Inc.'s Purpose, Vision and Values.

Read More

Find a Career

Health Care Analytics

Provide strategic analysis that impacts business decisions, improves efficiency and drives innovation.

Read More

Find a Career

 
 

Human Resources

Lead our workforce and workplace talent strategies, to accomplish our vision to be recognized as America’s valued health partner.

Read More

Find a Career

Information Technology

Lead our workforce and workplace talent strategies, to accomplish our vision to be recognized as America's valued health partner.

Read More

Find a Career

 
 

Metrics & Data

Leverage your talents to make a difference in people's lives, by providing innovative, data-driven solutions that can measure and track progress in our members' health.

Read More

Find a Career

Medical

Drive the future of health care, by helping us improve health outcomes and quality of life for our associates, members and communities.

Read More

Find a Career

Underwriting

Work in areas of specialty as varied as Life & Disability Underwriting, Pre-Sales, Retention and Implementation, Risk Analysis and Medical Evidence Underwriting.

Read More

Find a Career

Operations

Stretch your analytic problem-solving skills while working on enterprise-level projects and cross-functional teams.

Read More

Find a Career

View All Jobs

Temporary Contract Opportunities

Associate
 Benefits

At Anthem, we’re in the business of taking care of people. In fact, everything we do is aimed at creating positive outcomes that make a difference in peoples’ lives, which of course includes our family of associates.

Learn More

Student Programs

Anthem continues to demonstrate the kind of visionary leadership needed to drive the future of health care. Our efforts and accomplishments have been recognized by numerous leading publications and organizations.

Learn More

Military and
 Veteran Careers

As one of America’s largest health benefits companies, we have a profound appreciation for service. Our organization proudly supports our nation’s active, reserve and veteran military service members and their spouses.

Learn More

Why Choose Anthem

Why is Anthem a respected industry leader? Our standards are high – for the service we provide our members and the support we show our associates. Every day, we answer the call – to do the right thing and to treat others with respect. This is the sense of purpose that leads Anthem to thrive, and which will ensure our future success, and yours.

 

Life at Anthem

How often do you get the chance to do something truly life-changing? If you work with us the answer is ... every day. Our determination to drive the future of health care is ambitious, but so are our people.

Learn More

Diversity & Inclusion

Diversity and inclusion play a major role in our success, because it’s more than just a philosophy to us, it drives our power to innovate. From our corporate culture and strategic partnerships, to our commitment to our associates, our customers and communities, diversity is foundational in everything we do.

Learn More