Senior Compliance Oversight Specialist

Centene Corporation • Remote-MO, MO

2d • $70,100 - $126,200 • Remote

About The Position

Participate in auditing, monitoring, and oversight of Centene’s corporate ethics and compliance program as it applies to Centene, its broker and distribution partners, subsidiaries, and third parties or subcontractors. Conduct activities to assess compliance with contractual and regulatory requirements, collaborate with business owners and external partners to drive remediation, and support compliance with government-sponsored health care program requirements. Educate brokers on audit findings, program requirements, policies, and procedures. Develop and deliver corrective action plans and monitor probationary periods and disciplinary actions. The role may be performed remotely from anywhere in the Continental United States.

The position prepares formal reports on findings and recommendations, routes compliance issues for research and resolution, and contributes to issue management by evaluating corrective action plans, tracking remediation through closure, and providing follow-up. It promotes awareness of the Enterprise Ethics and Compliance Program and supports the development and maintenance of monitoring and auditing tools. The work includes assessing new or amended government-sponsored health care program contracts and requirements, identifying compliance risks, and advising business units and third parties in specialized areas including claims and payments, credentialing, network management, and financial solvency. Other duties may be assigned, and the employee must comply with all policies and standards.

Requirements

• Bachelor’s degree in healthcare, audit, business, or a related field, or equivalent experience; alternatively, a high school diploma/GED and at least 5 years of related experience.
• Ability to work with audit, oversight, monitoring, compliance issues, corrective action plans, and government-sponsored health care program requirements.

Nice To Haves

• Certified Healthcare Compliance (CHC) certification.
• Certified Internal Auditor (CIA) certification.

Responsibilities

• Conduct audits, oversight, and monitoring to assess compliance with contractual and regulatory requirements.
• Collaborate with business owners, brokers, distribution partners, and third parties or subcontractors to drive remediation and support compliance with government-sponsored health care program requirements.
• Educate brokers on audit findings, program requirements, and policies and procedures.
• Create and deliver corrective action plans and monitor probationary periods and disciplinary actions.
• Prepare formal written reports on audit, oversight, and monitoring findings and recommendations.
• Direct compliance issues to appropriate channels for research and resolution.
• Review and evaluate the status and effectiveness of corrective action plans, track issues through remediation and closure, and provide follow-up.
• Promote awareness of the Enterprise Ethics and Compliance Program, related compliance issues, policies, and procedures, and effective oversight and monitoring.
• Support management in developing and maintaining monitoring and auditing tools to evaluate compliance by internal organizations, brokers, distribution partners, and third parties or subcontractors.
• Educate, encourage, and assist company personnel and third parties or subcontractors in maintaining integrity and meeting government-sponsored health care program requirements.
• Assist in assessing new and amended government-sponsored health care program contracts and requirements.
• Assist health plans, subsidiaries, shared services, and third parties or subcontractors in identifying and assessing compliance risks.
• Serve as a compliance advisor to business units and third parties, with specialized focus that may include claims and payments, credentialing, network management, and financial solvency.
• Perform other duties as assigned and comply with all policies and standards.

Benefits

• Competitive pay.
• Health insurance.
• 401(k) and stock purchase plans.
• Tuition reimbursement.
• Paid time off and holidays.
• Flexible work arrangements, including remote, hybrid, field, or office schedules.

What This Job Offers

• Job Type: Full-time
• Career Level: Senior