Compliance & Reporting Specialist

Centene Corporation•Remote-SC, SC

1d•$56,200 - $101,000

About The Position

Develop, implement, and perform compliance auditing, monitoring, and reporting activities based on established programs, policies, and practices to ensure and maintain compliance with federal, state, and local regulatory and contractual requirements. The role develops and maintains quality and compliance reports and dashboards; reviews deliverables and data reports for timely submission, trends, and improvement opportunities; and performs audits, risk assessments, and documentation activities. The specialist investigates and resolves compliance issues, develops corrective action plans, and serves as the primary contact for compliance activities, including training and awareness programs. The role also designs and improves regulatory documentation and processes, researches markets and primary-source verification to determine licensure requirements, manages ongoing licensure maintenance, supports vendor oversight activities, and updates management on compliance and contract deliverables. Other duties may be assigned, and the role must comply with all policies and standards. Applicants must be authorized to work in the U.S. without current or future employment-based visa sponsorship. Centene describes its work as supporting access to healthcare and improving the lives of individuals, families, and communities. Work schedules may be remote, hybrid, field, or office. Compensation may include incentives, and benefits are subject to program eligibility.

Requirements

Bachelor’s degree in health care administration, compliance, or a related field, or equivalent experience.
2–4 years of compliance, regulatory, or related experience.
Experience with risk assessment requirements, auditing and reporting processes, action plans, and compliance training.
Experience with state/regulatory reporting, auditing and monitoring, risk assessment, action plans, and compliance training.
Exceptional attention to detail and organization, with the ability to manage recurring deadlines across multiple reports.
Strong written and verbal communication skills, including the ability to follow up firmly and professionally with report owners and approvers.
Proficiency with Microsoft Office, SharePoint, and Archer or similar GRC tools.
Authorization to work in the U.S. without the need for current or future employment-based visa sponsorship.

Nice To Haves

Medicaid managed care experience.
North Carolina reporting experience.

Responsibilities

Develop and maintain quality and compliance reports and dashboards.
Review and analyze deliverables and data reports to ensure timely submission, identify performance trends, and find opportunities for improvement.
Perform and monitor audits, risk assessments, and documentation activities to ensure compliance.
Identify, investigate, and resolve compliance issues and develop corrective action plans to mitigate future risks.
Serve as the primary contact for compliance activities, including training and awareness programs.
Design, implement, and improve regulatory documentation and processes addressing federal and state regulatory requirements, contract requirements, and company standards.
Research new markets and perform primary-source verification to determine licensure requirements; administer ongoing licensure maintenance.
Assist with vendor activities, including documentation of pre- and annual delegate oversight and ongoing vendor oversight and partnership activities.
Update management on compliance status and activities, contract deliverables, and related activities.
Perform other duties as assigned and comply with all policies and standards.