Director, Compliance Program Administration

Centene Corporation • Northampton, MA

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 job have the flexibility to work remote from home anywhere in the Continental United States. Position Purpose: Conduct compliance audits, write corrective action plans and work with contract and department managers to ensure timely completion and compliance with local, state and regulatory requirements. Represent the key leadership position for compliance at the health plan, oversee communication, coordinate of policy development and ensure accurate and timely communication to all departments. Investigate instances of suspected fraud within the health plan and report to appropriate management and regulatory entities. Assist management with enforcement and discipline in appropriate instances of non •compliance. Regularly inform health plan’s Board of Directors of the status of and activities pertaining to compliance. Performs other duties as assigned Complies with all policies and standards Education/Experience: Bachelor’s degree in related field or equivalent experience. 5+ years of compliance program management and contract experience with State Medicaid programs including internal and State audits; 2+ years experience in the development of compliance and fraud programs; 2 years experience with overseeing implementation of contract requirements. Previous management experience including responsibilities for hiring, training, assigning work and managing performance of staff. Compliance/ERM: 7+ years experience preferred

Requirements

• Bachelor’s degree in related field or equivalent experience.
• 5+ years of compliance program management and contract experience with State Medicaid programs including internal and State audits
• 2+ years experience in the development of compliance and fraud programs
• 2 years experience with overseeing implementation of contract requirements
• Previous management experience including responsibilities for hiring, training, assigning work and managing performance of staff.

Nice To Haves

• 7+ years experience preferred

Responsibilities

• Conduct compliance audits
• Write corrective action plans
• Work with contract and department managers to ensure timely completion and compliance with local, state and regulatory requirements
• Represent the key leadership position for compliance at the health plan
• Oversee communication
• Coordinate of policy development
• Ensure accurate and timely communication to all departments
• Investigate instances of suspected fraud within the health plan and report to appropriate management and regulatory entities
• Assist management with enforcement and discipline in appropriate instances of non •compliance
• Regularly inform health plan’s Board of Directors of the status of and activities pertaining to compliance
• Performs other duties as assigned
• Complies with all policies and standards

Benefits

• 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, including full-time or part-time status.
• Total compensation may also include additional forms of incentives.
• Benefits may be subject to program eligibility.

What This Job Offers

• Job Type: Full-time
• Career Level: Director
• Number of Employees: 5,001-10,000 employees