Compliance Analyst

Centene Corporation•St. David's, MO

1d•Remote

About The Position

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 for this role will have the flexibility to work remotely anywhere in the Continental United States. Position Purpose: The Compliance Analyst reviews and analyzes new and existing laws, regulations and policies for their impact on the Medicaid line of business. This position monitors and helps to ensure compliance with regulations in accordance with the specific areas they support. Educates Compliance associates on regulatory and legal issues. Reviews and monitors policies and procedures to ensure compliance with regulations. May help draft policies and procedures in response to changes and updates of specific laws and regulations. Assists with the implementation of new policies and procedures that affect compliance Research and analyzes regulatory requirements as needed to ensure compliance. Interprets regulations regarding benefits and provides information and education to Health Plan associates. Monitors compliance in regard to regulatory related communications including training and manuals Assists with informing management and Health Plan associates of changes or updates to regulatory requirements. Assists in the coordination of responses for Corrective Action Plans, inquiries, follow-up, reporting and any other requests. Assist in the preparation of materials and requirements for regulatory audits May act as subject matter expert in reviews of Request for Proposals (“RFPs”) and non-standard contracts with large employer groups. Performs other duties as assigned Comply with all policies and standards

Requirements

Bachelor’s degree in business or related field
Three years’ experience in compliance-related field, preferably in healthcare
Three to five years’ experience in Medicaid contracts

Responsibilities

Reviews and analyzes new and existing laws, regulations and policies for their impact on the Medicaid line of business
Monitors and helps to ensure compliance with regulations in accordance with the specific areas they support
Educates Compliance associates on regulatory and legal issues
Reviews and monitors policies and procedures to ensure compliance with regulations
May help draft policies and procedures in response to changes and updates of specific laws and regulations
Assists with the implementation of new policies and procedures that affect compliance
Research and analyzes regulatory requirements as needed to ensure compliance
Interprets regulations regarding benefits and provides information and education to Health Plan associates
Monitors compliance in regard to regulatory related communications including training and manuals
Assists with informing management and Health Plan associates of changes or updates to regulatory requirements
Assists in the coordination of responses for Corrective Action Plans, inquiries, follow-up, reporting and any other requests
Assist in the preparation of materials and requirements for regulatory audits
May act as subject matter expert in reviews of Request for Proposals (“RFPs”) and non-standard contracts with large employer groups
Performs other duties as assigned
Comply with all policies and standards