Manager, Compliance Policy Oversight

Centene Corporation

2d•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: Manage and implement strategies to ensure successful maintenance and implementation of compliance programs that meet regulatory requirements for assigned products across the entire company Manage an end-to-end policy life cycle and governance processes Maintain clear policy standards, templates, and guidance to support consistent, high quality policy writing across the organization Support responses to audits, regulatory inquiries, and internal reviews related to company policies and procedures Investigate issues and mitigate any potential violations including: gathering information and recommending a course of action, preparing reports by researching, analyzing and summarizing information Develop, implement and maintain production and quality standards for the compliance program. Perform periodic audits, risk assessments and conduct related ongoing compliance monitoring activities. Evaluate and implement changes to service functions and performance in relation to company mission, philosophy objectives and policies. Plan, direct and coordinate the implementation of policy decisions and ensure compliance with the company’s strategic plan, establish the department’s strategic vision, objectives and attendant policies and procedures for the organization. Research and incorporate best practices into operations and ensure that department functions are coordinated with other operating departments.

Requirements

Bachelors’ degree in related field or equivalent experience.
4+ years of compliance experience, preferably in a healthcare environment with at least 2+ years of Medicaid, Medicare or Commercial Managed Care experience.

Nice To Haves

Master's or Juris Doctorate degree preferred.
Previous experience demonstrating effective interaction with federal and state regulatory agencies in a managed care or insurance environment preferred.

Responsibilities

Manage and implement strategies to ensure successful maintenance and implementation of compliance programs that meet regulatory requirements for assigned products across the entire company
Manage an end-to-end policy life cycle and governance processes
Maintain clear policy standards, templates, and guidance to support consistent, high quality policy writing across the organization
Support responses to audits, regulatory inquiries, and internal reviews related to company policies and procedures
Investigate issues and mitigate any potential violations including: gathering information and recommending a course of action, preparing reports by researching, analyzing and summarizing information
Develop, implement and maintain production and quality standards for the compliance program.
Perform periodic audits, risk assessments and conduct related ongoing compliance monitoring activities.
Evaluate and implement changes to service functions and performance in relation to company mission, philosophy objectives and policies.
Plan, direct and coordinate the implementation of policy decisions and ensure compliance with the company’s strategic plan, establish the department’s strategic vision, objectives and attendant policies and procedures for the organization.
Research and incorporate best practices into operations and ensure that department functions are coordinated with other operating departments.