Compliance Corrections Specialist

🔥 0 minutes ago

🏰 Missouri – Remote

🏰 Missouri – Remote

💵 $56.2k - $101k / year

⏰ Full Time

🟡 Mid-level

🟠 Senior

🚔 Compliance

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Centene Corporation

WebsiteLinkedInAll Job Openings

10,000+ employees

Founded 1984

⚕️ Healthcare Insurance

🤝 Non-profit

🌍 Social Impact

Healthcare Insurance • Non-profit • Social Impact

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

• 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

🎯 Requirements

• 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

🏖️ 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