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Compliance Manager
hace 2 meses
Centene is seeking a highly skilled Compliance Manager to join our team. As a Compliance Manager, you will be responsible for managing and implementing strategies to ensure successful maintenance and implementation of compliance programs that meet regulatory requirements for assigned products across the entire company.
Key Responsibilities- 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 processes 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.
- 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.
- Oversee and ensure regulatory reports are monitored for submission.
- Bachelor's degree in related field or equivalent experience.
- Master's or Juris Doctorate degree preferred.
- 4+ years of compliance experience, preferably in a healthcare environment with at least 2+ 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.
- Previous leadership experience strongly preferred.
- Intermediate to advanced Excel skills strongly preferred.
- Competitive pay.
- Health insurance.
- 401K and stock purchase plans.
- Tuition reimbursement.
- Paid time off plus holidays.
- A flexible approach to work with remote, hybrid, field or office work schedules.
