Senior Compliance Analyst

🔥 8 minutes ago

🐊 Florida, Illinois, +7 more states – Remote

🐊 Florida – Remote 🌽 Illinois – Remote 🏖️ New Jersey – Remote 🗽 New York – Remote 🚗 Michigan – Remote ❄️ Minnesota – Remote 🔔 Pennsylvania – Remote 🤠 Texas – Remote ⚔️ Virginia – Remote

💵 $70.1k - $126.2k / year

⏰ Full Time

🟠 Senior

🚔 Compliance

👻 Ghost score 0%

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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

• Assist in maintaining Centene Corporation’s Compliance Program • Provide regulatory interpretation and perform compliance reporting • Lead special projects • Develop and implement compliance auditing and monitoring strategies • Respond to external requests for information required for regulatory filings • Manage compliance reporting and respond to state and federal regulatory agency inquiries • Manage ethics and compliance projects or implementations • Review and synthesize regulatory requirements and create policy or position statements • Assist with annual code of conduct attestation and remediation • Communicate state and federal requirements to internal and external clients • Develop, implement, and maintain compliance policies, procedures, and work instructions • Identify, analyze, and resolve compliance issues • Maintain and review regulatory documentation • Develop, produce, and conduct compliance training programs • Perform compliance audits, risk assessments, and ongoing monitoring activities • Assist health plans with regulatory agency relationships and policy issues • Assist management with interim health plan compliance officer responsibilities • Coordinate implementation of Compliance Committee policy • Serve as a company-wide resource and liaison on policies, contracts, communications, workflow, and quality improvements • For Pennsylvania Health & Wellness, manage FWA risk and trend tracking, coordinate cross-functional fraud workflows, ensure regulatory compliance, lead the monthly fraud workgroup, submit the quarterly MCO FWA report, and liaise with DHS Bureau of Program Integrity and the OAG

🎯 Requirements

• Must be authorized to work in the U.S. without the need for employment-based visa sponsorship now or in the future • Bachelor’s degree in related legal field or equivalent experience • Master’s or Juris Doctorate degree preferred and maybe considered in lieu of experience • 3+ years of related experience in compliance privacy and/or regulatory affairs • Experience in project management • Working knowledge of laws and/or regulations in compliance, particularly HIPAA and state regulations • Requires CFE (Certified Fraud Examiner) for Pennsylvania Health & Wellness responsibilities

🏖️ 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 • Equal opportunity employment • Consideration of qualified applicants with arrest or conviction records in accordance with applicable laws