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: Lead a team within Compliance Corrections responsible for the remediation and reporting activities to ensure successful resolution of identified non-compliance with Medicaid, Medicare, Marketplace, and Commercial regulatory requirements, contractual obligations and Company policies and procedures. Supports the internal and external corrective action plan lifecycle and related reporting. Partners with Product Compliance teams, Shared Services leadership, and market leaders to ensure successful and timely remediation of identified compliance issues. Lead and manage the assessment, and prioritization of non-compliance issues referred to the Corrections team. Oversee the execution and continuous improvement of the Corrections Compliance program, ensuring alignment with organizational standards. Provide regular updates on program performance to senior management and key stakeholders. Recruit, supervise, and develop team members in support of the organization’s mission and culture. Identify and recommend strategic improvements that significantly impact organizational goals and performance. Respond to inquiries from internal stakeholders and leadership regarding compliance matters. Offer expert guidance to departments on non-compliance issues and the progress of remediation efforts. Influence management to enhance performance and support leadership in achieving organizational objectives. Foster trusted, collaborative relationships with leadership to ensure active engagement in the Corrections process. Serve as the designated point of contact in the absence of the Senior Director of Compliance Corrections. Performs other duties as assigned. Complies with all policies and standards.

Requirements

  • Bachelor's Degree Business Administration, Public Policy, Public Health, or Health Administration or related field; or equivalent experience required
  • 5+ years Compliance experience, preferably in a healthcare environment required
  • 3+ years Medicaid, Medicare or Commercial Managed Care experience preferred
  • 2+ years Supervisory or management experience required

Nice To Haves

  • Master's Degree Business Administration, Public Policy, Public Health, or Health Administration preferred
  • Juris Doctor (JD) preferred
  • Previous experience demonstrating effective interaction with federal and state regulatory agencies in a manage care or insurance environment preferred.

Responsibilities

  • Lead a team within Compliance Corrections responsible for the remediation and reporting activities to ensure successful resolution of identified non-compliance with Medicaid, Medicare, Marketplace, and Commercial regulatory requirements, contractual obligations and Company policies and procedures.
  • Supports the internal and external corrective action plan lifecycle and related reporting.
  • Partners with Product Compliance teams, Shared Services leadership, and market leaders to ensure successful and timely remediation of identified compliance issues.
  • Lead and manage the assessment, and prioritization of non-compliance issues referred to the Corrections team.
  • Oversee the execution and continuous improvement of the Corrections Compliance program, ensuring alignment with organizational standards.
  • Provide regular updates on program performance to senior management and key stakeholders.
  • Recruit, supervise, and develop team members in support of the organization’s mission and culture.
  • Identify and recommend strategic improvements that significantly impact organizational goals and performance.
  • Respond to inquiries from internal stakeholders and leadership regarding compliance matters.
  • Offer expert guidance to departments on non-compliance issues and the progress of remediation efforts.
  • Influence management to enhance performance and support leadership in achieving organizational objectives.
  • Foster trusted, collaborative relationships with leadership to ensure active engagement in the Corrections process.
  • Serve as the designated point of contact in the absence of the Senior Director of Compliance Corrections.
  • Performs other duties as assigned.
  • Complies with all policies and standards.

Benefits

  • competitive pay
  • health insurance
  • 401K and stock purchase plans
  • tuition reimbursement
  • paid time off plus holidays
  • a flexible approach to work with remote, hybrid, field or office work schedules.
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