Compliance Corrections Specialist

🕒 4 dias atrás

🏰 Missouri – Remoto

🏰 Missouri – Remote

💵 $56.200 - $101.000 / ano

⏰ Tempo Integral

🟡 Pleno

🟠 Sênior

🚔 Conformidade

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Centene Corporation

SiteLinkedInTodas as Vagas

10.000+ funcionários

Fundada em 1984

⚕️ Seguro de Saúde

🤝 Sem Fins Lucrativos

🌍 Impacto Social

Healthcare Insurance • Non-profit • Social Impact

Centene Corporation é uma provedora líder de serviços de saúde patrocinados pelo governo, especializada em oferecer soluções de saúde acessíveis e de alta qualidade. Há mais de 40 anos, a Centene tem se dedicado a transformar a saúde das comunidades, ampliando o acesso a Medicaid, Medicare e ao Health Insurance Marketplace, além de atender comunidades militares por meio do programa TRICARE. Como a maior organização de managed care do Medicaid e participante-chave no Marketplace, a Centene enfatiza a entrega de cuidados de saúde com foco local, combinada a parcerias sólidas com organizações sem fins lucrativos para atender às necessidades únicas de seus membros. A Centene também é comprometida com sustentabilidade corporativa e responsabilidade social, priorizando a gestão ambiental e a governança ética para promover o bem-estar das comunidades que atende.

Descrição

• Participates in the oversight of Centene's and/or its third parties/subcontractor's corporate ethics and compliance program • Conducts focused reviews and audit, oversight, and monitoring of activities to assess compliance with Centene's contractual and regulatory requirements • Collaborates with business owners and/or third parties/subcontractors to drive remediation and assist Centene and third parties/subcontractors to maintain integrity through oversight and monitoring • Intakes and triages compliance issues based on defined risk criteria and signs out to other team members as needed • Ensures 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 • Supports corrections reporting providing meaningful trend analysis for business stakeholders and senior leadership

🎯 Requisitos

• Bachelor's Degree in Managed Care/Health Insurance or related field; or equivalent experience required • 3+ years of experience in Managed Care, Health Care, Health Insurance or related field required • 1+ years experience in project oversight type role with demonstrated ability to drive implementation and influence others preferred • 1+ years experience in reading, analyzing, and interpreting State and Federal laws, rules and regulations preferred • 1+ years experience in State Medicaid or Federal managed care compliance preferred • Certified in HealthCare Compliance (CHC) preferred

🏖️ Benefícios

• Competitive pay • Health insurance • 401K and stock purchase plans • Tuition reimbursement • Paid time off plus holidays • Flexible approach to work with remote, hybrid, field or office work schedules