Job Description
Job Description: • Leads the integrity and governance of Centene's and/or its vendors corporate ethics and compliance program • ongoing oversight and analysis of regulatory compliance practices • Collaborates with internal teams and external vendors or subcontractors to promote contract compliance and uphold program integrity • Oversee the management of the entire contract lifecycle, from drafting to finalization • Conducts reviews, audits, and assessments of vendor relationships to ensure adherence to Centene and Government-sponsored health care program Requirements. • Collaborates with business owners and vendors to drive process improvements • Leads the timely, consistent, and accurate communication of state and federal regulatory updates impacting Medicaid and Marketplace regulatory filings • Prepares, organizes, and packages subcontractor files for approval/notification • Develop clear, accurate and timely written reports detailing oversight and monitoring findings and recommendations • Ensures all supporting documentation and workpapers meet Centene and department standards • Partners with internal departments and subcontractors to route compliance concerns to the appropriate channels for investigation and resolution • Supports regulatory notifications and documentation of approvals/notifications Requirements: • Bachelor's Degree in related field; or, equivalent experience required • Master's Degree preferred • Juris Doctor (JD) preferred • 4+ years Managed Care/Health Insurance and knowledge of relevant legal and regulatory frameworks required • 2+ years Project oversight with demonstrated ability to drive implementation and influence others preferred • 2+ years Reading, analyzing, and interpreting State and Federal laws, rules and regulations preferred • 2+ years State Medicaid or government sponsored healthcare compliance preferred • HealthCare Compliance (CHC) preferred Benefits: • competitive pay • health insurance • 401K and stock purchase plans • tuition reimbursement • paid time off plus holidays • flexible approach to work with remote, hybrid, field or office work schedules Apply tot his job Apply tot his job
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