Compliance Manager, Management

Compliance Manager

Location: This role requires associates to be in-office 1 - 2 days per week, fostering collaboration and connectivity, while providing flexibility to support productivity and work-life balance. This approach combines structured office engagement with the autonomy of virtual work, promoting a dynamic and adaptable workplace.
Norfolk, VA highly preferred. Alternate locations may be considered if candidates reside within a commuting distance from an office.

Please note that per our policy on hybrid/virtual work, candidates not within a reasonable commuting distance from the posting location(s) will not be considered for employment, unless an accommodation is granted as required by law.

The Compliance Manager serves as a key leader within the Carelon Insights Payment Integrity Regulatory Compliance (PIRC) organization, with primary responsibility for the oversight and management of Commercial Compliance activities. This position plays a vital role in ensuring the organization’s adherence to regulatory requirements, maintaining operational excellence, and advancing Carelon Insights Payment Integrity compliance objectives across multiple commercial markets.

• Provides strategic direction and oversight for regulatory audits and examinations, internal audits, accreditations, risk assessments, and other compliance reviews.
• Developing and executing audit plans, conducting gap analyses, managing audit preparedness, coordinating evidence collection, and delivering regular leadership updates on compliance status and risk mitigation efforts.
• Serves as a subject matter expert, maintaining an advanced understanding of applicable laws, regulations, and company policies to anticipate compliance risks, assess potential impacts, and guide decision‑making.
• Oversees several critical compliance tools and processes, including PI SME for the CONTRAXX system, Doctract and Service Now (SNOW) issue management.
• Ensures that all compliance mandates are effectively tracked, resolved, and documented in a timely manner.
• The position also partners closely with cross‑functional stakeholders, including business leaders, regulators, and internal governance teams, to promote transparency, accountability, and consistent adherence to compliance standards.
• This position requires strategic thinking, sound judgment, and the ability to navigate a highly regulated and dynamic environment.
• Serve as a trusted advisor and compliance leader within the Payment Integrity organization, strengthening regulatory alignment, reducing risk exposure, and supporting a culture of integrity and continuous improvement.

Requires a BA/BS and minimum of 6 years health care, regulatory, ethics, compliance or privacy experience; or any combination of education and experience, which would provide an equivalent background.

• An advanced degree (MS, MBA, or JD) or a professional certification (e.g., CHC, CCEP, CHPC) is preferred.
• Candidates should possess demonstrated experience leading compliance programs or audits of moderate to high complexity, along with exceptional communication, analytical, and leadership skills.
• Commercial compliance experience preferred.
• Demonstrated success leading compliance programs or audits of moderate to high complexity.
• Strong communication, analytical, and leadership skills.
• Proven ability to assess regulatory impacts, manage risk, and implement effective compliance solutions.
• Experience with compliance tools and systems such as SharePoint, Doctract, CONTRAXX, or Service Now.

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 elevancehealthj for assistance.

Qualified applicants with arrest or conviction records will be considered for employment in accordance with all federal, state, and local laws, including, but not limited to, the Los Angeles County Fair Chance Ordinance and the California Fair Chance Act.