Manager, Enterprise Compliance Corrections

Centene

4d•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: Manages team within the Compliance Corrections department responsible for remediation of non-compliance issues with Medicaid, Medicare, Marketplace, and Commercial regulatory requirements, contractual obligations, and Company policies and procedures. Supports data integrity and reporting related to the internal and external corrective action plan lifecycle. Ensures data quality, interprets non-compliance trends, and develops Corrections reporting methodology in conjunction with Compliance leadership. Develops policies, procedures, and process to comply with federal program regulations, and any applicable state regulations. Develops reports and deliverables and make recommendations to management. Identifies recommendations that have a significant impact on organization goals and objectives. Appropriately influences management to improve performance and assist leadership in meeting organization goals. Assists management in driving business decisions based on data. Manages compliance reporting responsibilities and respond to inquiries from stakeholders and leaders within the organization. Assists in the identification, analysis, and resolution of compliance issues. Communicates program status to management and key stakeholders. Maintains trusted, collaborative relationships with leadership to promote an appropriate level of engagement in the Corrections process. Hires, manages, and develops direct reports that supports the organization mission. Performs other duties as assigned. Complies with all policies and standards.

Requirements

Bachelor's Degree in Business Administration, Public Policy, Public Health, or Health Administration or related field; or equivalent experience required
4+ years Compliance experience, preferable in healthcare environment required
1+ years Medicaid, Medicare or Commercial Managed Care experience required

Nice To Haves

Master's Degree in Business Administration, Public Policy, Public Health, or Health Administration or related field preferred
2+ years Supervisory or management experience preferred
Previous experience demonstrating effective interaction with federal and state regulatory agencies in a manage care or insurance environment preferred

Responsibilities

Manages team within the Compliance Corrections department responsible for remediation of non-compliance issues with Medicaid, Medicare, Marketplace, and Commercial regulatory requirements, contractual obligations, and Company policies and procedures.
Supports data integrity and reporting related to the internal and external corrective action plan lifecycle.
Ensures data quality, interprets non-compliance trends, and develops Corrections reporting methodology in conjunction with Compliance leadership.
Develops policies, procedures, and process to comply with federal program regulations, and any applicable state regulations.
Develops reports and deliverables and make recommendations to management.
Identifies recommendations that have a significant impact on organization goals and objectives.
Appropriately influences management to improve performance and assist leadership in meeting organization goals.
Assists management in driving business decisions based on data.
Manages compliance reporting responsibilities and respond to inquiries from stakeholders and leaders within the organization.
Assists in the identification, analysis, and resolution of compliance issues.
Communicates program status to management and key stakeholders.
Maintains trusted, collaborative relationships with leadership to promote an appropriate level of engagement in the Corrections process.
Hires, manages, and develops direct reports that supports the organization mission.
Performs other duties as assigned.
Complies with all policies and standards.