Senior Compliance Analyst, Duals (DSNP) Products

Centene Corporation•Remote-MO, MO

5d•$70,100 - $126,200•Remote

About The Position

Centene is seeking a Senior Compliance Analyst, Duals (DSNP) Products to partner with leadership in maintaining compliance with Duals (D-SNP) Program requirements. This role involves providing regulatory interpretation, performing compliance reporting, leading special projects, and developing and implementing compliance auditing and monitoring strategies for D-SNPs. The position also responds to external requests for information for regulatory filings, manages compliance reporting responsibilities, and responds to inquiries from state and federal regulatory agencies. The analyst will lead Duals compliance projects, review and synthesize regulatory requirements, create policy statements, and partner with leadership to manage annual SMAC assessments and tracking of caps. Communication of Duals requirements to internal and external clients, and providing development guidance for compliance policies and procedures are key responsibilities. The role involves leading the identification, analysis, and resolution of Duals compliance issues, maintaining D-SNP regulatory documentation, and partnering in the development and delivery of compliance training programs. Periodic compliance audits, risk assessments, and related monitoring activities will be performed. The analyst will also partner with the Duals Manager and health plans in managing relationships with regulatory agencies and may perform interim Duals Compliance Manager responsibilities, serving as a company-wide resource and liaison on various compliance-related matters.

Requirements

Bachelor's Degree Law or related field; or, equivalent experience required
4+ years Compliance and/or regulatory affairs required
Experience in project management with working knowledge of laws and/or regulations in area of compliance, in particular Medicare, D-SNP, and state regulations required

Responsibilities

Partners with leadership in maintaining Centene Corporation's Compliance with Duals (D-SNP) Program requirements.
Provide regulatory interpretation, perform compliance reporting, lead special projects, and develop and implement compliance auditing and monitoring strategies for the D-SNPs.
Responds to external requests for information required by the organization for its Duals and SMAC regulatory filings.
Manages Duals (and Medicare with D-DSNP specific or separate) compliance reporting responsibilities and respond to inquiries from state and federal regulatory agencies.
Leads Duals compliance projects or implementations.
Reviews and synthesizes Duals regulatory requirements and create policy and/or position statements.
Partners with leadership to manage annual SMAC assessment and tracking of caps.
Communicate Duals (state and federal) requirements to internal and external clients.
Provides development guidance and leads the identification, implementation, and maintenance of Duals and overlapping Medicare compliance policies, procedures and work instructions.
Leads the identification, analysis, and resolution of Duals compliance issues.
Maintains and reviews D-SNP regulatory documentation necessary to maintain corporate standards.
Partners with leadership in developing, producing and conducting Duals compliance training programs.
Perform periodic compliance audits, risk assessments and conducts related to ongoing Duals compliance monitoring activities.
Partners with Duals Manager and health plans in managing relationships with regulatory agencies and seek to confirmation and clarification of D-SNP requirements and implementations where needed.
Performs interim Duals Compliance manager responsibilities to include supporting the health plan compliance officer with D-SNP specific responsibilities.
Serve as a company-wide resource and liaison on policies, contract issues and provisions, communications, workflow, and quality improvements initiatives.
Serves as a company-wide resource and liaison on Duals policies, SMAC items and provisions, communications, workflow, and quality improvements initiatives.
Performs other duties as assigned.
Complies with all policies and standards.