Lead Compliance Oversight

Centene Corporation•Remote-MO, MO

4d•Remote

About The Position

The Lead Compliance Oversight position performs and/or leads compliance-related projects and assessments from planning through reporting. The role reviews the work of staff and senior compliance specialists and ensures completion of internal and external corrective action plans. It serves as a departmental subject matter expert and may mentor staff and interns. The position may be performed remotely from home anywhere in the Continental United States. The role provides guidance and mentoring to department associates, coordinates with other departments to route compliance issues for research and resolution, and consults management, in-house counsel, and/or the VP of Corporate Compliance on difficult matters. It promotes awareness of the Corporate Ethics and Compliance Program and relevant compliance issues, policies, procedures, and internal audits. The position also works with Corporate Compliance management on project status and deliverables, conducts independent evaluations of business processes, internal controls, and regulatory compliance, and ensures oversight testing, documentation, and reporting meet quality, timeliness, and professional standards. The position tracks corrective action plans to completion; supports compliance with State Medicaid Programs and OIG and CMS requirements; coordinates with external auditors; helps prepare the annual compliance risk profile and monthly, quarterly, and annual reports for senior management and the Board of Directors; and develops and/or executes compliance monitoring and oversight work plans. Other projects may be assigned.

Requirements

Bachelor's degree in a related field, or an additional two years of Compliance/Auditing experience in lieu of the degree.
At least 5 years of Compliance/Auditing experience.
At least 3 years of experience in State or Federal Managed Care Programs.
At least 1 year of experience reading, analyzing, and interpreting State and Federal laws, rules, and regulations.

Nice To Haves

Certified in HealthCare Compliance (CHC).
Certified Compliance Ethics Professional (CCEP).
Certified Internal Auditor (CIA).
Certified Fraud Examiner (CFE).

Responsibilities

Provide work guidance, direction, and mentoring to department associates.
Collaborate with other departments to route compliance issues for research and resolution; consult management, in-house counsel, and/or the VP of Corporate Compliance as needed on difficult issues.
Promote awareness of the Corporate Ethics and Compliance Program, compliance issues, related policies and procedures, and internal compliance audits among health plan staff.
Coordinate with Corporate Compliance management regarding project status and assigned deliverables.
Provide independent appraisals, analyses, and observations evaluating business processes, internal controls, and regulatory compliance.
Ensure monitoring and oversight testing, documentation, and reporting are completed with quality, on time, and in accordance with professional standards.
Ensure internal and external corrective action plans are tracked to completion.
Educate, encourage, and assist company personnel in maintaining integrity through oversight and monitoring and meeting State Medicaid Programs, OIG, and CMS requirements.
Communicate and coordinate with external auditors.
Assist Corporate Audit & Oversight management in preparing the annual compliance risk profile.
Develop and/or execute compliance monitoring and oversight work plans.
Assist Corporate Audit & Oversight management in preparing monthly, quarterly, and annual reports for senior management and the Board of Directors.
Perform other projects as assigned.