Senior Manager, Ethics & Compliance (Internal Audit)

Centene Corporation

1d•Remote

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: Manage and implement strategies to ensure successful maintenance and implementation of compliance programs that meet regulatory requirements for assigned products across the entire company Ensure all Medicare and Medicaid product and services are being tested for compliance with program regulations, insurance regulations, and regulatory requirements for business entities. Maintain and track laws and regulations, contract documentations, amendments, and various compliance measures. Develop policies, procedures, and process to comply with federal program regulations, and any applicable state regulations. Provide guidance to various departments regarding compliance issues and implementation of new compliance requirements with respect to regulatory and contract language. Conduct compliance audits, develop and implement corrective action plans. Perform plan risk assessments and report emerging trends, deficiencies and variances; report findings to other departments and teams as appropriate. Provide required Ethics, Compliance, Risk Management, FWA, privacy, and security training for existing and new employees and as required non-employees. Provide mentoring and guidance to subordinates within the department as necessary. Serve as primary backup to department lead as necessary. Performs other duties as assigned. Complies with all policies and standards.

Requirements

Bachelor's Degree Healthcare Administration, Compliance or related field; or equivalent experience required.
5+ years Compliance experience required
3+ years Medicaid, Medicare or commercial Managed Care required
Prior experience working with federal and state regulatory agencies in a managed care or insurance environment preferred

Nice To Haves

Master's Degree preferred
Juris Doctor (JD) preferred
Certified Internal Auditor (CIA) certification preferred

Responsibilities

Manage and implement strategies to ensure successful maintenance and implementation of compliance programs that meet regulatory requirements for assigned products across the entire company
Ensure all Medicare and Medicaid product and services are being tested for compliance with program regulations, insurance regulations, and regulatory requirements for business entities.
Maintain and track laws and regulations, contract documentations, amendments, and various compliance measures.
Develop policies, procedures, and process to comply with federal program regulations, and any applicable state regulations.
Provide guidance to various departments regarding compliance issues and implementation of new compliance requirements with respect to regulatory and contract language.
Conduct compliance audits, develop and implement corrective action plans.
Perform plan risk assessments and report emerging trends, deficiencies and variances; report findings to other departments and teams as appropriate.
Provide required Ethics, Compliance, Risk Management, FWA, privacy, and security training for existing and new employees and as required non-employees.
Provide mentoring and guidance to subordinates within the department as necessary.
Serve as primary backup to department lead as necessary.
Performs other duties as assigned.
Complies with all policies and standards.