Job Description

Position Title:

US Regulatory Compliance & Legal research -Sr Associate Compliance (IND)- BF-38546-62042 - JR187754

Job Family:

FRD > Compliance

Shift:

Job Title

Sr Associate Compliance

Requirement Type

Full-Time Employee

Job Location

Bangalore/Gurgaon

Requirement Level

I10

Hiring Manager

Sr Mgr Ethics & Compliance

Primary Skill

50-state legal/regulatory research(Westlaw/Lexis/NILS); US Regulatory compliance, US Legal reserach

Business

Ethics & Compliance

Skill Category

Generic

ABOUT ELEVANCE HEALTH

Elevance Health is a leading health company in America dedicated to improving lives and communities and making healthcare simpler. It is the largest managed health care company in the Blue Cross Blue Shield (BCBS) Association serving more than 45 million lives across 14 states.

A regular in Fortune 500 list, Elevance Health ranked 20 in 2022. Gail Boudreaux, President and CEO of Elevance Health has been a consistent name in the Fortune list of most powerful women and currently holds 4th rank on this list.

ABOUT CARELONCARELON

Carelon Global Solutions (CGS) is a healthcare solutions company that is simplifying complex operational processes to improve the health of the healthcare system.

Previously known as Legato Health Technologies, Carelon Global Solutions (hereinafter, CGS) underwent a name change and joined the Carelon family of brands in January 2023, as a fully owned subsidiary of Elevance Health (Previously Anthem Inc.). CGS brings together a global team of like-minded innovators who manage and optimize operational processes for health plans as well as providers.

Our brightest minds housed across our global headquarters in Indianapolis as well as Bengaluru, Hyderabad and Gurugram in India, Manila in the Philippines, Limerick in Ireland and San Juan in Puerto Rico bring with them innovative capabilities and an unmatched depth of experience. This global team uniquely positions CGS to enable scalable, next-generation platforms and specialized digital tools that make healthcare operations more practical, effective and efficient.

OUR MISSION & VALUES

Our Mission: Improving Lives and Communities. Simplifying Healthcare. Expecting More.
Our Values: Leadership | Community | Integrity | Agility | Diversity

JOB POSITION

We are seeking a Compliance professional (J.D. strongly preferred) with strong U.S. legal research and state licensing experience related to HMOs, Insurers, Third Party Administrators (TPAs), Utilization Management (UM), and Pharmacy Benefit Managers (PBMs). This role will support enterprise licensing strategy, interpret evolving state regulatory requirements, and drive licensing applications/renewals while partnering closely with Legal, Compliance, and Operations.

JOB RESPONSIBILITY

• Conduct and synthesize 50-state legal research on licensing and regulatory requirements for HMO, Insurer, TPA, UM, and PBM activities (including scope, definitions, exemptions, and operational obligations).

• Prepare clear internal guidance (memos, matrices, summaries) translating statutes/regulations, bulletins, and DOI guidance into practical requirements.

• Manage or support state licensing lifecycle activities: new applications, renewals, amendments, change of control/ownership, name/address changes, officer and director changes, reporting, attestations, and surety bonds.

• Coordinate licensing submissions with onshore associates, including tracking status, responding to deficiency letters, and maintaining regulatory correspondence.

• Partner with business stakeholders to understand products/operations and determine when activities trigger licensure or related registrations.

• Monitor and communicate changes in laws, regulations, and regulator guidance; propose action plans to maintain compliance.

QUALIFICATION

• Demonstrated experience performing U.S. legal research (statutes, regulations, administrative guidance; Westlaw/Lexis and/or NILS experience a plus).
• Practical familiarity with regulatory frameworks affecting one or more of:
  • Health Maintenance Organization (HMO) licensing
  • Insurer Licensing
  • Third Party Administrator (TPA) licensing
  • Utilization Management / UR / UM licensing or certification
  • Pharmacy Benefit Manager (PBM) licensing and related compliance requirements
• Strong writing skills: ability to produce concise, well-supported analyses and guidance.
• Strong project management skills: ability to manage multiple state workstreams, deadlines, and dependencies.

High attention to detail and comfort working with documentation-heavy filings

EXPERIENCE

• Demonstrated experience performing U.S. legal research (statutes, regulations, administrative guidance; Westlaw/Lexis and/or NILS experience a plus).
• Practical familiarity with regulatory frameworks affecting one or more of:
  • Health Maintenance Organization (HMO) licensing
  • Insurer Licensing
  • Third Party Administrator (TPA) licensing
  • Utilization Management / UR / UM licensing or certification
  • Pharmacy Benefit Manager (PBM) licensing and related compliance requirements
• Strong writing skills: ability to produce concise, well-supported analyses and guidance.
• Strong project management skills: ability to manage multiple state workstreams, deadlines, and dependencies.

High attention to detail and comfort working with documentation-heavy filings

SKILLS AND COMPETENCIES

• 50-state legal/regulatory research (Westlaw/Lexis/NILS)
• Regulatory analysis & issue-spotting (licensing triggers, exemptions, operational obligations)
• Licensing lifecycle management & filings (applications, renewals, amendments; change events; deficiency responses; regulator correspondence)
• Project management (multi-state tracking, deadlines, dependencies, escalation)
• Strong written communication (memos, matrices, internal guidance, regulator-facing responses)
• Documentation control & attention to detail (filing accuracy, recordkeeping/audit readiness)
• Cross-functional stakeholder management (Legal/Compliance/Operations)
• Organized, deadline-driven, and comfortable with ambiguity

Assists in Vendor Management and Sourcing team to meet the contractual requirements. By establishing regular contract administrative activities, improve supplier performance and mitigate the risk.

Assists in establishing contract management objectives and annual goals. Identifies, investigates, and resolves contractual/service deliverables issues, and provides oversight and assistance with procedure guidelines. Resolves rebuttal issues, provides ongoing feedback to the respective teams regarding the performance of the suppliers.

THE CARELON PROMISE

Aligning with our brand belief of ‘limitless minds are our biggest asset’, we offer a world of limitless opportunities to our associates.

It is our strong belief that one is committed to a role when it is not just what the role entails, but also what lies in its periphery that completes the value circle for an associate.

This world of limitless opportunities thrives in an environment that fosters growth and well-being, and gives you purpose and the feeling of belonging.

LIFE @ CARELON

• Extensive focus on learning and development
• An inspiring culture built on innovation, creativity, and freedom.
• Holistic well-being
• Comprehensive range of rewards and recognitions
• Competitive health and medical insurance coverage
• Best-in-class amenities and workspaces
• Policies designed with associates at the center.

EQUAL OPPORTUNITY EMPLOYER

Carelon is committed to a diverse and inclusive workplace and is proud to be an equal opportunity employer. All qualified applicants will receive consideration for employment without regard to race, color, religion, gender identity or expression, sexual orientation, national origin, genetics, pregnancy, disability, age, veteran status, or other characteristics.

Reasonable Accommodation

Our inclusive culture empowers Carelon to deliver the best results for our customers. We not only celebrate the diversity of our workforce, but we also celebrate the diverse ways we work.

If you have a disability and need accommodation such as an interpreter or a different interview format, please ask for the Reasonable Accommodation Request Form.

*Disclaimer: Offered designation titles differ*

Job Type:

Full time