Director, Compliance

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 force that brings us to work each day. We believe in embracing new ideas, challenging 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--62% in year-over-year revenue growth through 2015. Are we recognized? Definitely. We're 12th on Forbes' list of America's Most Promising Companies for 2015, one of "Becker's 150 Great Places to Work in Healthcare" in 2016, and our CEO was number one on Glassdoor's 2015 Highest-Rated CEOs for Small and Medium Companies. 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.
What You'll Be Doing:
The Director, Compliance will help direct Evolent's compliance oversight and delegation oversight program, based on state and federal regulatory requirements and best practices. This position designs and conducts audits (both internal and of delegates) based on internal risk assessments. This position also works closely with Evolent operational, clinical and legal teams to ensure that Evolent is fulfilling its obligations to its clients as a first tier delegate. In addition, this individual will serve as a compliance resource to Evolent's Medicare operations.
Serves as a subject matter expert in compliance (Medicare Advantage preferred) and oversees development and maintenance of programs in accordance with CMS and state regulatory requirements.
Regularly interacts with clients, consulting on compliance best practices and coordinating with downstream delegates to ensure client compliance requirements are met.
Monitors newly enacted legislation, regulations, sub-regulatory guidance and instructions to determine impact on Evolent, and delegated entities.
Conducts regular meetings with key business owners to address new compliance and/or regulatory requirements and provide oversight of implementation.
Works closely in coordination with the senior members of the Compliance team to conduct risk assessments and audits, as necessary,
Assists with the development of tools and educational materials for Evolent's compliance and delegation oversight program, in accordance with state and federal regulatory requirements.
The Experience You Need (Required):
Bachelor's Degree
4 -6 years of professional experience in federal health plan compliance programs
Professional experience in one or more of the following: Medicare Part C, Medicare Part D, Medicare Shared Savings, and Medicaid programs
Experience with monitoring and auditing
Finishing Touches (Preferred):
Compliance certification (CHC or similar)
Master Degree in healthcare or related field or Juris Doctor
Strong written and oral communication and presentation skills
Ability to prioritize and manage simultaneous projects with minimal supervision
Collaborative working style
Comfortable working in an extremely dynamic environment
Strong sense of ethics
Roll-up sleeves attitude
Evolent Health is an Equal Opportunity/Affirmative Action Employer

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