Compliance Oversight Specialist – Non Clinical

🔥 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

🛡️ 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

• Participate in oversight of WellCare's and/or delegated subcontractors' corporate ethics and compliance programs • Conduct focused reviews, audits, oversight, and monitoring activities to assess contractual and regulatory compliance • Collaborate with business owners and delegated vendors to drive remediation • Assist WellCare and delegated subcontractors in meeting Government-sponsored health care program requirements • Assess new and amended Government-sponsored health care program contracts and requirements • Assist local Markets, corporate Shared Services, and delegated subcontractors in identifying and assessing compliance risks • Evaluate the effectiveness of compliance programs, policies, and procedures • Prepare timely formal written reports on findings and recommendations • Prepare workpapers in accordance with departmental standards and maintain sufficient evidentiary material • Direct compliance issues to appropriate channels for research and resolution • Review and evaluate corrective action plans and provide follow-up to stakeholders, senior management, oversight committees, and the Board's Audit, Finance, and Regulatory Compliance Committee • Participate in special projects, including training • Perform other duties as assigned • Comply with all policies and standards

🎯 Requirements

• Bachelor's Degree in a related field, or Associate's degree with 4 years of applicable experience, or HSD/GED with 5 years of applicable experience in lieu of Bachelor's degree required • 3+ years of experience in Managed Care/Health Insurance required • 1+ year of experience in a project oversight role with demonstrated ability to drive implementation and influence others preferred • 1+ year of experience reading, analyzing, and interpreting State and Federal laws, rules, and regulations preferred • 1+ year of experience in State Medicaid or Federal managed care compliance preferred • Certified in HealthCare Compliance (CHC) preferred • Compliance with all applicable policies and standards • Qualified applicants must meet applicable legal employment requirements

🏖️ 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 • Additional forms of incentives may be included in total compensation • Accommodation support for candidates