You could be the one who changes everything for our 28 million members. Centene is transforming the health of our communities, one person at a time.
As a diversified, national organization, you’ll have access to competitive benefits including a fresh perspective on workplace flexibility.
Applicants in this role must reside in the Columbus, Ohio area and come into the office every Wednesday.
Position Purpose : Manage and implement strategies to ensure successful maintenance and implementation of compliance programs that meet regulatory requirements for assigned products across the entire company.
- Lead Vendor Oversight and Management process, including Contract review, regulatory communications and submissions, and tracking vendor performance.
- Ensure all Medicare and Medicaid product and services are being tested for compliance with program regulations, insurance regulations, and regulatory requirements for business entities.
- Maintain and track laws and regulations, contract documentations, amendments, and various compliance measures.
- Develop policies, procedures, and process to comply with federal program regulations, and any applicable state regulations.
- Provide guidance to various departments regarding compliance issues and implementation of new compliance requirements with respect to regulatory and contract language.
- Conduct compliance audits, develop and implement corrective action plans.
- Perform plan risk assessments and report emerging trends, deficiencies and variances, report findings to other departments and teams as appropriate.
- Provide required Ethics, Compliance, Risk Management, FWA, privacy, and security training for existing and new employees and as required non-employees.
- Provide mentoring and guidance to subordinates within the department as necessary.
- Serve as primary backup to department lead as necessary.
Knowledge / Experience :
- Bachelors’ degree in related field or equivalent experience. Master's or Juris Doctorate degree highly preferred.
- 5+ years of compliance experience, preferably in a healthcare environment with at least 3+ years of Medicaid, Medicare or Commercial Managed Care experience.
Previous experience demonstrating effective interaction with federal and state regulatory agencies in a managed care or insurance environment preferred.
Pay Range : $103,500.00 - $191,600.00 per year
Centene offers a comprehensive benefits package including : competitive pay, health insurance, 401K and stock purchase plans, tuition reimbursement, paid time off plus holidays, and a flexible approach to work with remote, hybrid, field or office work schedules.
Actual pay will be adjusted based on an individual's skills, experience, education, and other job-related factors permitted by law.
Total compensation may also include additional forms of incentives.
Senior Manager, Ethics & Compliance
Provide guidance to various departments regarding compliance issues and implementation of new compliance requirements with respect to regulatory and contract language. Provide required Ethics, Compliance, Risk Management, FWA, privacy, and security training for existing and new employees and as requ...
Senior Manager, Ethics & Compliance
Provide guidance to various departments regarding compliance issues and implementation of new compliance requirements with respect to regulatory and contract language. Provide required Ethics, Compliance, Risk Management, FWA, privacy, and security training for existing and new employees and as requ...
Senior Manager, Controls Assurance & IT Compliance Audit
Job Title : Senior Manager, Controls Assurance & IT Compliance Audit. As a key liaison for external auditors that issue the reports and internal IT and business teams, the Senior Manager ensures comprehensive pro...
Manager of Security, Quality, Compliance and Ethics
Security, Quality, Compliance and Ethics also works with managers and supervisors to ensure employees and contractors comply with all quality, compliance and ethics. Security, Quality, Compliance and Ethics serves as a Project Manager to oversee and execute all Risk Assessment, report writing, secur...
Manager / Senior Manager, Compliance & Reporting Specialist
Manager / Senior Manager, Compliance & Reporting Specialist. KPMG is currently seeking a Manager / Senior Manager to join our Global Compliance Management Services practice. Additional Responsibilities for Senior Manager:. Additional Qualifications for Senior Manager:. ...
Senior Program Manager, Compliance Engineering
Senior Program Manager,pliance EngineeringEvery day, Global Payments makes it possible for millions of people to move money between buyers and sellers using our payments solutions for credit, debit, prepaid and merchant services. Barriers to entry such as technicalmittee and senior management review...
Senior Data Analyst
Collaboratively manage and lead data projects - including business requirements and timelines - that impact process, procedure and practices related to the use of data or data integrations. This position will coach, train and mentor strategic business unit staff and other staff on guidelines, standa...
Senior Legal Counsel
The Senior Legal Counsel provides a variety of general corporate, regulatory, and commercial legal services to the organization and its in-house clients and will also provide legal services to support one or more specific market segments and/or products in the organization. May manage legal matters ...
Project Manager
We are looking for an experienced Project Manager to join our Enterprise Project and Change Management office (PCMO) team. We provide project management and change management expertise to help our internal clients implement their vision. Project manage enterprise-wide initiatives, to include pl...
Senior Quality Assurance Compliance Specialist
Are you passionate about significantly improving the future of medicine? Do you believe that people are the most important asset of any company? If so, join .R&D work, a preclinical CRO performing safety efficacy and toxicology studies for small molecules and advanced therapies alike, and, most ...