Senior Compliance and Vendor Management Oversight Specialist

Centene Corporation•Remote-MO, MO

3d•$70,100 - $126,200•Remote

About The Position

Leads the integrity and governance of Centene's and/or its vendors corporate ethics and compliance program, and ongoing oversight and analysis of regulatory compliance practices. Collaborates with internal teams and external vendors or subcontractors to promote contract compliance and uphold program integrity through structured oversight and monitoring of government-sponsored healthcare programs. Oversee the management of the entire contract lifecycle, from drafting to finalization, ensuring compliance and mitigating risks. Conducts reviews, audits, and assessments of vendor relationships to ensure adherence to Centene's and Government-sponsored health care program Requirements. Collaborates with business owners and vendors to drive process improvements, maintaining integrity, and ensuring compliance with Government-sponsored healthcare program requirements. Leads the timely, consistent, and accurate communication of state and federal regulatory updates impacting Medicaid and Marketplace regulatory filings in collaboration with market and product compliance officers. Prepares, organizes, and package subcontractor files for approval/notification. Develop clear, accurate and timely written reports detailing oversight and monitoring findings and recommendations. Ensures all supporting documentation and workpapers meet Centene and department standards, including the inclusion of sufficient evidence to substantiate findings. Partners with internal departments and subcontractors to route compliance concerns to the appropriate channels for investigation and resolution. Supports regulatory notifications and documentation of approvals/notifications. Performs other duties as assigned. Complies with all policies and standards.

Requirements

Bachelor's Degree in related field; or, equivalent experience.
4+ years Managed Care/Health Insurance and knowledge of relevant legal and regulatory frameworks required

Nice To Haves

Master's Degree preferred
Juris Doctor (JD) preferred
2+ years Project oversight with demonstrated ability to drive implementation and influence others preferred
2+ years Reading, analyzing, and interpreting State and Federal laws, rules and regulations preferred
2+ years State Medicaid or government sponsored healthcare compliance preferred
HealthCare Compliance (CHC) preferred

Responsibilities

Leads the integrity and governance of Centene's and/or its vendors corporate ethics and compliance program, and ongoing oversight and analysis of regulatory compliance practices.
Collaborates with internal teams and external vendors or subcontractors to promote contract compliance and uphold program integrity through structured oversight and monitoring of government-sponsored healthcare programs.
Oversee the management of the entire contract lifecycle, from drafting to finalization, ensuring compliance and mitigating risks.
Conducts reviews, audits, and assessments of vendor relationships to ensure adherence to Centene's and Government-sponsored health care program Requirements.
Collaborates with business owners and vendors to drive process improvements, maintaining integrity, and ensuring compliance with Government-sponsored healthcare program requirements.
Leads the timely, consistent, and accurate communication of state and federal regulatory updates impacting Medicaid and Marketplace regulatory filings in collaboration with market and product compliance officers.
Prepares, organizes, and package subcontractor files for approval/notification.
Develop clear, accurate and timely written reports detailing oversight and monitoring findings and recommendations.
Ensures all supporting documentation and workpapers meet Centene and department standards, including the inclusion of sufficient evidence to substantiate findings.
Partners with internal departments and subcontractors to route compliance concerns to the appropriate channels for investigation and resolution.
Supports regulatory notifications and documentation of approvals/notifications.
Performs other duties as assigned.
Complies with all policies and standards.