Senior Compliance Analyst, Duals DSNP Products

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🔥 0 minutes ago

🏰 Missouri – Remote

🏰 Missouri – Remote

💵 $70.1k - $126.2k / year

⏰ Full Time

🟠 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

• Partner with leadership to maintain compliance with Duals (D-SNP) Program requirements • Provide regulatory interpretation and perform compliance reporting • Lead special projects and develop and implement compliance auditing and monitoring strategies for D-SNPs • Respond to external information requests required for Duals and SMAC regulatory filings • Manage Duals and Medicare D-DSNP compliance reporting responsibilities and regulatory inquiries • Lead Duals compliance projects and implementations • Review and synthesize Duals regulatory requirements and create policies or position statements • Manage the annual SMAC assessment and track caps • Communicate state and federal Duals requirements to internal and external clients • Guide development and lead identification, implementation, and maintenance of Duals and overlapping Medicare compliance policies, procedures, and work instructions • Identify, analyze, and resolve Duals compliance issues • Maintain and review D-SNP regulatory documentation • Develop, produce, and conduct Duals compliance training programs • Perform periodic compliance audits, risk assessments, and ongoing monitoring activities • Manage relationships with regulatory agencies and seek confirmation and clarification of D-SNP requirements and implementations • Perform interim Duals Compliance Manager responsibilities, including supporting health plan compliance officers with D-SNP responsibilities • Serve as a company-wide resource and liaison on Duals policies, SMAC items, contract provisions, communications, workflow, and quality improvement initiatives • Perform other duties as assigned and comply with all policies and standards

🎯 Requirements

• Bachelor's Degree in Law or related field, or equivalent experience required • 4+ years of compliance and/or regulatory affairs experience required • Experience in project management • Working knowledge of laws and/or regulations related to compliance • Knowledge of Medicare, D-SNP, and state regulations required

🏖️ 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 • Incentive compensation may be available • Accommodation support for applicants