Compliance Officer, Mississippi

Centene Corporation•Remote-MS, MS

7d•Hybrid

About The Position

Centene is seeking a Compliance Officer for its Mississippi health plan. This role is crucial for transforming the health of communities by overseeing all compliance functions, including policy development, and ensuring accurate and timely submission of various regulatory requirements such as CMS Medicare SNP requirements and over-contract deliverables. The Compliance Officer will serve as the primary point of contact for state regulators, Department of Insurance, and HHSC audits, managing all aspects of these interactions. Additionally, the role involves significant engagement with Enterprise Risk Management, conducting internal audits, developing corrective action plans, and overseeing compliance for subcontractors. The position requires the candidate to reside in Mississippi and work from the office at least once a week.

Requirements

Bachelor's Degree in a related field, or equivalent experience required.
7+ years of Compliance program management and contract experience with State Medicaid programs, including internal and State audits, required.
5+ years of experience with Health care regulatory agencies in the development of compliance and fraud programs, required.
5+ years of experience overseeing the implementation of contract requirements, required.
Must reside in the state of Mississippi.
Must go into the office at least once a week.

Nice To Haves

Master's Degree in a related field preferred.
10+ years of Compliance/Enterprise Risk Management experience preferred.

Responsibilities

Oversee all compliance functions for the Mississippi health plan, including communication and coordination of policy development.
Oversee the accurate and timely submission of over-contract deliverables for all lines of business and service delivery areas.
Oversee the accurate and timely submission of all CMS Medicare SNP requirements.
Serve as senior leadership and single point of contact in all State compliance meetings and interactions.
Manage direct correspondence and daily interaction with all state regulators.
Serve as senior leadership in all Department of Insurance and HHSC audit processes, managing all facets of the audit and communications.
Serve as senior leadership in Enterprise Risk Management process, working directly with corporate ERM and Executive Management team to ensure current evaluation and documentation of business risks.
Conduct internal compliance audits, write corrective action plans, and work with contract and department managers to ensure timely completion and compliance with federal, state, and local regulatory requirements.
Manage and oversee compliance for all health plan material subcontractors, including directing the performance of annual oversight.
Perform other duties as assigned.
Comply with all policies and standards.