Senior Compliance Corrections Specialist

Centene Corporation•Remote-MO, MO

3d•$70,100 - $126,200•Remote

About The Position

Participates in corrections process for all lines of business. Responsibilities include intaking and triaging suspected issues of non-compliance, entry of compliance issues into GRC tool and assignment/coordination of issues to corrections team members. Collaborates with compliance and business stakeholders to gather information, develop corrective action plans, identify and escalate barriers to progress and gather evidence of remediation. Updates GRC tool to support corrections reporting. Collaborates with compliance and business stakeholders to ensure adequate root cause analysis and development of corrective actions plans to effectively address non-compliance. Reviews and oversees progress towards remediation and documented key milestones in GRC tool. Identifies issues that require escalation and ensures they are addressed timely through established paths and processes. Conducts review of evidence to address root cause of issue and facilitate timely closure of issues. Develops, implements and continually refines corrections reporting that provides meaningful trend analysis for business stakeholders and senior leadership on new, in progress and closed issues as well as regulatory sanctions. Supports management in the development and maintenance of corrections processes and tools designed to effectively remediate compliance issues in a timely manner, ensure timely escalation and sustainable resolutions. Educates, encourages, and assists those within the company to maintain integrity through correction of identified non-compliance in order to meet the requirements of Government-sponsored health care programs. Performs other duties as assigned Complies with all policies and standards

Requirements

Bachelor's Degree in Managed Care/Health Insurance or related field, or equivalent experience required
5+ years experience in Managed Care/Health Insurance or related experience required
Excellent Microsoft Office skills preferred

Nice To Haves

Experience with data analytics preferred
Certified in HealthCare Compliance (CHC) preferred
Certified Compliance & Ethics Professional (CCEP) preferred

Responsibilities

Intaking and triaging suspected issues of non-compliance
Entry of compliance issues into GRC tool and assignment/coordination of issues to corrections team members
Collaborating with compliance and business stakeholders to gather information, develop corrective action plans, identify and escalate barriers to progress and gather evidence of remediation
Updating GRC tool to support corrections reporting
Ensuring adequate root cause analysis and development of corrective actions plans to effectively address non-compliance
Reviewing and overseeing progress towards remediation and documented key milestones in GRC tool
Identifying issues that require escalation and ensuring they are addressed timely through established paths and processes
Conducting review of evidence to address root cause of issue and facilitate timely closure of issues
Developing, implementing and continually refining corrections reporting that provides meaningful trend analysis for business stakeholders and senior leadership on new, in progress and closed issues as well as regulatory sanctions
Supporting management in the development and maintenance of corrections processes and tools designed to effectively remediate compliance issues in a timely manner, ensure timely escalation and sustainable resolutions
Educating, encouraging, and assisting those within the company to maintain integrity through correction of identified non-compliance in order to meet the requirements of Government-sponsored health care programs
Performing other duties as assigned
Complying with all policies and standards