Lead Compliance Oversight

Job not on LinkedIn

🔥 0 minutes ago

🏰 Missouri – Remote

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⏰ Full Time

🟠 Senior

🚔 Compliance

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Logo of Centene Corporation

Centene Corporation

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

• Perform and/or lead compliance-related projects and assessments from planning through reporting • Review staff and senior compliance specialists' work • Ensure completion of internal and external corrective action plans • Serve as a subject matter expert and mentor staff and/or interns • Provide work guidance, direction, and mentoring to department associates • Collaborate with departments to direct compliance issues for research and resolution • Consult with management, in-house counsel, and/or the VP of Corporate Compliance on difficult compliance issues • Communicate the importance of compliance and the compliance program to health plan staff • Promote awareness of the Corporate Ethics and Compliance Program, compliance issues, policies, procedures, and internal compliance audits • Coordinate with Corporate Compliance management regarding project status and deliverables • Provide independent appraisals, analyses, and observations of business processes, internal controls, and regulatory compliance • Ensure monitoring and oversight testing, documentation, and reporting meet quality, timeliness, and professional standards • Track internal and external corrective action plans to completion • Educate, encourage, and assist employees in meeting State Medicaid Programs, OIG, and CMS requirements • Communicate and coordinate with external auditors • Assist with the annual compliance risk profile and develop and/or execute compliance monitoring and oversight work plans • Assist with monthly, quarterly, and annual reporting to senior management and the Board of Directors • Perform other assigned projects

🎯 Requirements

• Bachelor's Degree in a related field; an additional 2 years of Compliance/Auditing experience may be substituted in lieu of the degree • 5+ years of experience in Compliance/Auditing required • 3+ years of experience in State or Federal Managed Care Programs required • 1+ year of experience in reading, analyzing, and interpreting State and Federal laws, rules and regulations required • Certified in HealthCare Compliance (CHC) preferred • Certified Compliance Ethics Professional (CCEP) preferred • Certified Internal Auditor (CIA) preferred • Certified Fraud Examiner (CFE) preferred

🏖️ Benefits

• Competitive pay • Health insurance • 401K plan • 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 • Diversity-focused equal opportunity employment

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