Compliance Officer

🕒 3 days ago

🏖️ New Jersey – Remote

🏖️ New Jersey – Remote

💵 $148k - $274.2k / year

⏰ Full Time

🟠 Senior

🔴 Lead

🚔 Compliance

Apply Now

Find Similar Remote Jobs

Set Up Email Alert For New Jobs

📊 Check your resume score for this job

Improve your chances of getting an interview by checking your resume score before you apply.

Upload Resume

Centene Corporation

WebsiteLinkedInAll Job Openings

10,000+ employees

Founded 1984

🛡️ Insurance

💼 Consulting

🏥 Healthcare

Insurance • Consulting • Healthcare

Centene Corporation is a leading provider of government-sponsored healthcare services, specializing in delivering affordable and high-quality healthcare solutions. For over 40 years, Centene has focused on transforming the health of communities by expanding access to Medicaid, Medicare, and Health Insurance Marketplace services, as well as serving military communities through the TRICARE program. As the largest Medicaid managed care organization and a key participant in the Marketplace, Centene emphasizes localized healthcare delivery combined with strong partnerships with nonprofit organizations to meet the unique needs of its members. Centene is also committed to corporate sustainability and social responsibility, prioritizing environmental stewardship and ethical governance to enhance the well-being of the communities it serves.

📋 Description

• Provide strategic leadership and oversight for the health plan compliance program, including compliance governance, regulatory strategy, policy development, and cross-functional implementation. • Ensure accurate and timely execution and regulatory deliverables across business and operational areas. • Lead the design, execution, and ongoing effectiveness of the market compliance program in alignment with enterprise standards and regulatory expectations. • Oversee compliance with CMS Medicare requirements including SNP related obligations, and ensure timely submission of all applicable regulatory filings and deliverables. • Serve as senior compliance leader and single point of contact for state interactions, compliance meetings and market level escalations. • Serve as senior leadership in all Department of Insurance, Medicaid agency, and other regulatory audit activities applicable to New Jersey market. • Collaborate with Corporate Enterprise Risk Management and market leaders to identify, assess, document, and reduce compliance and business risks. • Internal compliance auditing and monitoring activities, direct corrective action planning, and hold business owners accountable for timely remediation and sustained compliance. • Provide oversight of delegated entities, vendors, and material subcontractors, including annual oversight performance monitoring and corrective action follow up. • Chair or support market compliance committees and provide regular reporting to market and enterprise leadership regarding risks, trends and remediation activities. • Lead, coach, and develop compliance team members, and establish clear priorities, accountabilities and performance expectations. • Maintain and track contract documentation, Medicaid contract amendments, and various regulatory measures.

🎯 Requirements

• Bachelor's Degree in related field, or equivalent experience required • Master's Degree in related field preferred • 7+ years Compliance program management and contract experience with State Medicaid programs including internal and State audits required • 5+ years Health care regulatory agencies in development of compliance and fraud programs; required • 5+ years Overseeing implementation of contract requirements required • 10+ years Compliance/Enterprise Risk Management preferred

🏖️ Benefits

• 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